Functional indicators for robotic medical systems

ABSTRACT

A robotic medical system can include a patient platform configured to support a patient during a robotic medical procedure, a column supporting the patient platform, and an arm support coupled to the column with at least one robotic arm coupled to the arm support. The system can also include an indicator positioned on at least one of the arm support and the patient platform, wherein the indicator is configured to indicate state or identity information of the system. The indicator can be a visual indicator.

PRIORITY APPLICATION

This application is a continuation-in-part of U.S. patent applicationSer. No. 17/127,007, filed Dec. 18, 2020, which claims priority to andbenefit from U.S. Provisional Application No. 62/951,799, filed Dec. 20,2019, which is incorporated herein by reference.

TECHNICAL FIELD

This application is directed to robotic medical systems, and moreparticularly, to functional indicators for robotic medical systems.

BACKGROUND

Medical procedures, such as laparoscopy or endoscopy, may involveaccessing and visualizing an internal region of a patient. In alaparoscopic procedure, for example, a medical instrument can beinserted into an internal region through a laparoscopic access port.Robotically-enabled medical system can be used to perform such medicalprocedures. The robotically-enabled medical systems may include severalrobotic components, including, for example, robotic arms, roboticinstrument manipulators, and robotic medical instruments, such asrobotically controllable laparoscopes or endoscopes.

SUMMARY

Robotic medical systems that include one or more robotic components canalso include functional indicators configured to communicate informationabout the system or its components. As initial examples, the functionalindicators can comprise visual indicators (e.g., lights) and/or audibleindicators (e.g., speakers). In some embodiments, the robotic medicalsystems can include one or more robotic arms positioned on adjustablearm supports configured to move to position the one or more robotic armsupports relative to a patient platform supporting a patient during arobotic medical procedure. The functional indicators can be positioned,for example, on the adjustable arm supports or a patient platform. Theindicators can be configured, for example, to provide state and/oridentity information associated with the system or its components. Theindicators can also be used in non-robotic systems as well.

In a first aspect, a robotic medical system includes a patient platformconfigured to support a patient during a robotic medical procedure; acolumn supporting the patient platform; an arm support coupled to thecolumn; at least one robotic arm coupled to the arm support; and anindicator positioned on at least one of the arm support and the patientplatform, wherein the indicator is configured to indicate state oridentity information of the system.

The system can include one or more of the following features in anycombination: (a) wherein the indicator comprises at least one of avisual indicator and an audible indicator; (b) wherein the arm supportcomprises an adjustable arm support configured to move the at least onerobotic arm relative to the patient platform; (c) wherein the adjustablearm support is configured to move the at least one robotic arm from astowed position below the patient platform to a deployed positionwherein at least a portion of the at least one robotic arm is positionedabove the patient platform; (d) wherein the arm support comprises a barextending along an axis between a first end and a second end, andwherein the at least one robotic arm is movably mounted to the bar suchthat the at least one robotic arm can translate along the bar; (e)wherein the indicator comprises a visual indicator; (f) wherein thevisual indicator is positioned on at least one of a top side, an outerside, an inner side, and a bottom side of the bar; (g) wherein thevisual indicator extends onto the first end and the second end of thebar; (h) wherein the visual indicator comprises a strip of lightemitting diodes (LEDs); (i) wherein the state information comprisesinformation about movement of at least one of the arm support and the atleast one robotic arm; (j) wherein the state information indicates adirection of movement of the arm support; (k) wherein the direction ofmovement comprises a sweeping movement of the arm support; (l) whereinthe direction of movement comprises a translating movement of the armsupport; (m) wherein the state information indicates a direction ofmovement of the at least one robotic arm along the arm support; (n)wherein the state information comprises an identifier for the at leastone robotic arm; (o) wherein the state information comprises first stateinformation and second state information; (p) wherein the first stateinformation comprises at least one of: a stand by state, a poweredstate, an active state, a ready state, an error state and an emergencystop state; (q) wherein the second state information is configured toindicate movement of the arm support; (r) wherein the visual indicatoris configured to indicate the first state information and the secondstate information concurrently; and/or (s) wherein the visual indicatoris configured to illuminate a zone around the system indicative of anarea through which the arm support will move to provide a visualindication of a zone of danger.

In another aspect, a robotic medical system includes a patient platformconfigured to support a patient during a robotic medical procedure; acolumn supporting the patient platform; an adjustable arm supportcoupled to the column and configured to move relative to the patientplatform, the adjustable arm support comprising a bar extending along anaxis between a first end and a second end; a first robotic arm coupledto the bar of the adjustable arm support and configured to translatealong the bar; a second robotic arm coupled to the bar of the adjustablearm support and configured to translate along the bar independently ofthe first robotic arm; and a light strip positioned on at least one ofthe patient platform and the bar of the adjustable arm support; and aprocessor in communication with a memory that stores instructions thatconfigured the processor to: determine a state of the robotic medicalsystem, and activate the light strip to convey the state of the roboticmedical system visually.

The system can include one or more of the following features in anycombination: (a) wherein the light strip comprises a strip ofindividually-addressable light emitting diodes (LEDs); (b) wherein thelight strip is positioned on at least one of a top side, an outer side,inner side, and a bottom side of the bar; (c) wherein the light stripextends onto the first end and the second end of the bar; (d) whereinthe state comprises a movement of the adjustable arm support, the firstrobotic arm, or the second robotic arm, and the processor is configuredto activate the light strip to convey a direction of the movement; (e)wherein the movement comprises a translation of the bar of theadjustable arm support or a translation of one of the first robotic armand the second robotic arm along the bar; (f) wherein the movementcomprises a sweeping movement of the bar of the adjustable arm support;(g) wherein the processor determines the state of the robotic medicalsystem based on a user input; (h) wherein the user input comprises acommanded motion for at least one of the first robotic arm and thesecond robotic arm; (i) wherein the user input comprises at least oneof: a stow command for transitioning the adjustable arm support, thefirst robotic arm, and the second arm support from a deployed positionto a stowed position; and a set up command for transitioning theadjustable arm support, the first robotic arm, and the second armsupport from a stowed position to a deployed position; and/or (j)wherein upon receipt of the stow command, the system is configured to,at least one of: move the adjustable arm support and the first roboticarm to a draping configuration; and move the adjustable arm support andthe first robotic arm to a pre-docking position.

In another aspect, a robotic medical system includes: a patient platformconfigured to support a patient during a robotic medical procedure; acolumn supporting the patient platform; an adjustable arm supportcoupled to the column and configured to move relative to the patientplatform, the adjustable arm support comprising a bar extending along anaxis between the first end and the second end; a first robotic armcoupled to the bar of the adjustable arm support and configured totranslate along the bar; and a visual indicator positioned on theadjustable arm support or the patient platform and configured tovisually identify the first robotic arm.

The system can include one or more of the following features in anycombination: (a) wherein the visual indicator comprises a light strip,and wherein a portion of the light strip is configured to illuminate toidentify the first robotic arm; (b) wherein the portion of the lightstrip that illuminates to identify the first robotic arm varies alongthe light strip as the first robotic arm translates along the bar; (c)wherein the light strip extends along the bar; (d) wherein the lightstrip extends along the patient platform; (e) a second robotic armcoupled to the bar of the adjustable arm support and configured totranslate along the bar independently of the first robotic arm, andwherein the visual indicator is configured to visually identify thesecond robotic arm; (f) wherein the visual indicator uniquely identifiesthe first robotic arm and the second robotic arm; (g) wherein the visualindicator uniquely identifies the first robotic arm and the secondrobotic arm using different color lights; (h) wherein the visualindicator is positioned on at least one of a top side, an outer side, aninner side, and a bottom side of the bar; (i) wherein the visualindicator extends onto the first end and the second end of the bar; (j)wherein the visual indicator is configured provide information based ona state of the robotic system; (k) wherein the state informationcomprises information about movement of the arm support and the firstrobotic arm; (l) wherein the state information indicates a direction ofmovement of the arm support; (m) wherein the direction of movementcomprises a sweeping movement of the arm support; (n) wherein thedirection of movement comprises a translating movement of the armsupport; (o) wherein the state information indicates a direction ofmovement of the first robotic arm along the arm support; (p) wherein thestate information comprises an identifier for the first robotic arm; (q)where in the state information comprises first state information andsecond state information; (r) wherein the first state informationcomprises at least one of: a stand by state, a powered state, an activestate, a ready state, an error state and an emergency stop state; (s)wherein the second state information is configured to indicate movementof the arm support; (t) wherein the visual indicator is configured toindicate the first state information and the second state informationconcurrently; and/or (u) wherein the visual indicator is configured toilluminate a zone around the system indicative of an area through whichthe arm support will move to provide a visual indication of a zone ofdanger.

BRIEF DESCRIPTION OF THE DRAWINGS

The disclosed aspects will hereinafter be described in conjunction withthe appended drawings, provided to illustrate and not to limit thedisclosed aspects, wherein like designations denote like elements.

FIG. 1 illustrates an embodiment of a cart-based robotic system arrangedfor diagnostic and/or therapeutic bronchoscopy.

FIG. 2 depicts further aspects of the robotic system of FIG. 1.

FIG. 3 illustrates an embodiment of the robotic system of FIG. 1arranged for ureteroscopy.

FIG. 4 illustrates an embodiment of the robotic system of FIG. 1arranged for a vascular procedure.

FIG. 5 illustrates an embodiment of a table-based robotic systemarranged for a bronchoscopic procedure.

FIG. 6 provides an alternative view of the robotic system of FIG. 5.

FIG. 7 illustrates an example system configured to stow robotic arm(s).

FIG. 8 illustrates an embodiment of a table-based robotic systemconfigured for a ureteroscopic procedure.

FIG. 9 illustrates an embodiment of a table-based robotic systemconfigured for a laparoscopic procedure.

FIG. 10 illustrates an embodiment of the table-based robotic system ofFIGS. 5-9 with pitch or tilt adjustment.

FIG. 11 provides a detailed illustration of the interface between thetable and the column of the table-based robotic system of FIGS. 5-10.

FIG. 12 illustrates an alternative embodiment of a table-based roboticsystem.

FIG. 13 illustrates an end view of the table-based robotic system ofFIG. 12.

FIG. 14 illustrates an end view of a table-based robotic system withrobotic arms attached thereto.

FIG. 15 illustrates an exemplary instrument driver.

FIG. 16 illustrates an exemplary medical instrument with a pairedinstrument driver.

FIG. 17 illustrates an alternative design for an instrument driver andinstrument where the axes of the drive units are parallel to the axis ofthe elongated shaft of the instrument.

FIG. 18 illustrates an instrument having an instrument-based insertionarchitecture.

FIG. 19 illustrates an exemplary controller.

FIG. 20 depicts a block diagram illustrating a localization system thatestimates a location of one or more elements of the robotic systems ofFIGS. 1-10, such as the location of the instrument of FIGS. 16-18, inaccordance to an example embodiment.

FIGS. 21A and 21B are perspective views of an embodiment of a roboticmedical system including functional indicators.

FIG. 21A illustrates the system with adjustable arm supports and roboticarms in an example stowed position below a patient platform.

FIG. 21B illustrates the system with the adjustable arm supports and therobotic arm in an example deployed position.

FIG. 22A illustrates an embodiment an adjustable arm support including afunctional indicator comprising an light emitting diode (LED) strip.

FIG. 22B illustrates an embodiment of an adjustable arm supportincluding a functional indicator comprising a plurality of discrete LEDsor discrete LED strips.

FIG. 22C illustrates another embodiment of an adjustable arm supportincluding a functional indicator comprising a plurality of discrete LEDsor discrete LED strips.

FIG. 22D illustrates an embodiment an adjustable arm support including afunctional indicator configured as a screen.

FIG. 23A illustrates a cross-sectional view of an embodiment of anadjustable arm support including functional indicators on outer andlower surfaces thereof.

FIG. 23B illustrates a cross-sectional view of another embodiment of anadjustable arm support including functional indicators on outer andlower surfaces thereof.

FIG. 24 illustrates a cross-sectional view of an adjustable arm supportincluding functional indicators comprising light guides.

FIG. 25 illustrates an embodiments of an adjustable arm supportincluding a plurality of different indicator zones.

FIG. 26 illustrates an embodiment of an adjustable arm support includingindicators configured as audio devices.

FIG. 27A illustrates a top view of an embodiment of a robotic medicalsystem including functional indicators configured to provide moodlighting around the system.

FIG. 27B illustrates a top view of an embodiment of a robotic medicalsystem including functional indicators configured to provide anindication of a keep out zone around the system.

FIG. 28A illustrates a side view of an embodiment of a robotic medicalsystem including functional indicators on an adjustable arm supportconfigured to provide an indication of motion of the adjustable armsupport.

FIG. 28B illustrates a side view of an embodiment of a robotic medicalsystem including functional indicators on an adjustable arm supportconfigured to provide an indication of possible pinching due to motionof the system.

FIG. 28C is a perspective view of an embodiment of a robotic medicalsystem including functional indicators on an adjustable arm supportconfigured to provide an indication of a sweeping motion of theadjustable arm support.

FIG. 28D is a perspective view of an embodiment of a robotic medicalsystem including functional indicators on an adjustable arm supportconfigured to provide an indication of translational motion of theadjustable arm support.

FIG. 29A is a perspective view of an embodiment of a robotic medicalsystem including functional indicators on an adjustable arm supportconfigured to provide identity information associated with robotic armsof the system.

FIG. 29B is a perspective view of an embodiment of a robotic medicalsystem including functional indicators on an adjustable arm supportconfigured to provide movement information associated with movement ofthe robotic arms of the system along the adjustable arm support.

FIG. 30 is a front view of an embodiment of a tower including functionalindicators, the functional indicators configured to provide informationassociated with robotic arms.

FIG. 31 is a perspective view of an embodiment of a tower includingfunctional indicators, the functional indicators configured to provideinformation associated with robotic arms.

FIG. 32 is a perspective view of a robotic medical system includingfunctional indicators on robotic arms configured to provide informationassociated with robotic arms.

FIG. 33 is a perspective view of a robotic medical system includingfunctional indicators on robotic arms configured to provide informationassociated with robotic arms.

DETAILED DESCRIPTION 1. Overview.

Aspects of the present disclosure may be integrated into arobotically-enabled medical system capable of performing a variety ofmedical procedures, including both minimally invasive, such aslaparoscopy, and non-invasive, such as endoscopy, procedures. Amongendoscopic procedures, the system may be capable of performingbronchoscopy, ureteroscopy, gastroscopy, etc.

In addition to performing the breadth of procedures, the system mayprovide additional benefits, such as enhanced imaging and guidance toassist the physician. Additionally, the system may provide the physicianwith the ability to perform the procedure from an ergonomic positionwithout the need for awkward arm motions and positions. Still further,the system may provide the physician with the ability to perform theprocedure with improved ease of use such that one or more of theinstruments of the system can be controlled by a single user.

Various embodiments will be described below in conjunction with thedrawings for purposes of illustration. It should be appreciated thatmany other implementations of the disclosed concepts are possible, andvarious advantages can be achieved with the disclosed implementations.Headings are included herein for reference and to aid in locatingvarious sections. These headings are not intended to limit the scope ofthe concepts described with respect thereto. Such concepts may haveapplicability throughout the entire specification.

A. Robotic System—Cart.

The robotically-enabled medical system may be configured in a variety ofways depending on the particular procedure. FIG. 1 illustrates anembodiment of a cart-based robotically-enabled system 10 arranged for adiagnostic and/or therapeutic bronchoscopy. During a bronchoscopy, thesystem 10 may comprise a cart 11 having one or more robotic arms 12 todeliver a medical instrument, such as a steerable endoscope 13, whichmay be a procedure-specific bronchoscope for bronchoscopy, to a naturalorifice access point (i.e., the mouth of the patient positioned on atable in the present example) to deliver diagnostic and/or therapeutictools. As shown, the cart 11 may be positioned proximate to thepatient's upper torso in order to provide access to the access point.Similarly, the robotic arms 12 may be actuated to position thebronchoscope relative to the access point. The arrangement in FIG. 1 mayalso be utilized when performing a gastro-intestinal (GI) procedure witha gastroscope, a specialized endoscope for GI procedures. FIG. 2 depictsan example embodiment of the cart in greater detail.

With continued reference to FIG. 1, once the cart 11 is properlypositioned, the robotic arms 12 may insert the steerable endoscope 13into the patient robotically, manually, or a combination thereof. Asshown, the steerable endoscope 13 may comprise at least two telescopingparts, such as an inner leader portion and an outer sheath portion, eachportion coupled to a separate instrument driver from the set ofinstrument drivers 28, each instrument driver coupled to the distal endof an individual robotic arm. This linear arrangement of the instrumentdrivers 28, which facilitates coaxially aligning the leader portion withthe sheath portion, creates a “virtual rail” 29 that may be repositionedin space by manipulating the one or more robotic arms 12 into differentangles and/or positions. The virtual rails described herein are depictedin the Figures using dashed lines, and accordingly the dashed lines donot depict any physical structure of the system. Translation of theinstrument drivers 28 along the virtual rail 29 telescopes the innerleader portion relative to the outer sheath portion or advances orretracts the endoscope 13 from the patient. The angle of the virtualrail 29 may be adjusted, translated, and pivoted based on clinicalapplication or physician preference. For example, in bronchoscopy, theangle and position of the virtual rail 29 as shown represents acompromise between providing physician access to the endoscope 13 whileminimizing friction that results from bending the endoscope 13 into thepatient's mouth.

The endoscope 13 may be directed down the patient's trachea and lungsafter insertion using precise commands from the robotic system untilreaching the target destination or operative site. In order to enhancenavigation through the patient's lung network and/or reach the desiredtarget, the endoscope 13 may be manipulated to telescopically extend theinner leader portion from the outer sheath portion to obtain enhancedarticulation and greater bend radius. The use of separate instrumentdrivers 28 also allows the leader portion and sheath portion to bedriven independently of each other.

For example, the endoscope 13 may be directed to deliver a biopsy needleto a target, such as, for example, a lesion or nodule within the lungsof a patient. The needle may be deployed down a working channel thatruns the length of the endoscope to obtain a tissue sample to beanalyzed by a pathologist. Depending on the pathology results,additional tools may be deployed down the working channel of theendoscope for additional biopsies. After identifying a nodule to bemalignant, the endoscope 13 may endoscopically deliver tools to resectthe potentially cancerous tissue. In some instances, diagnostic andtherapeutic treatments can be delivered in separate procedures. In thosecircumstances, the endoscope 13 may also be used to deliver a fiducialto “mark” the location of the target nodule as well. In other instances,diagnostic and therapeutic treatments may be delivered during the sameprocedure.

The system 10 may also include a movable tower 30, which may beconnected via support cables to the cart 11 to provide support forcontrols, electronics, fluidics, optics, sensors, and/or power to thecart 11. Placing such functionality in the tower 30 allows for a smallerform factor cart 11 that may be more easily adjusted and/orre-positioned by an operating physician and his/her staff. Additionally,the division of functionality between the cart/table and the supporttower 30 reduces operating room clutter and facilitates improvingclinical workflow. While the cart 11 may be positioned close to thepatient, the tower 30 may be stowed in a remote location to stay out ofthe way during a procedure.

In support of the robotic systems described above, the tower 30 mayinclude component(s) of a computer-based control system that storescomputer program instructions, for example, within a non-transitorycomputer-readable storage medium such as a persistent magnetic storagedrive, solid state drive, etc. The execution of those instructions,whether the execution occurs in the tower 30 or the cart 11, may controlthe entire system or sub-system(s) thereof. For example, when executedby a processor of the computer system, the instructions may cause thecomponents of the robotics system to actuate the relevant carriages andarm mounts, actuate the robotics arms, and control the medicalinstruments. For example, in response to receiving the control signal,the motors in the joints of the robotics arms may position the arms intoa certain posture.

The tower 30 may also include a pump, flow meter, valve control, and/orfluid access in order to provide controlled irrigation and aspirationcapabilities to the system that may be deployed through the endoscope13. These components may also be controlled using the computer system ofthe tower 30. In some embodiments, irrigation and aspirationcapabilities may be delivered directly to the endoscope 13 throughseparate cable(s).

The tower 30 may include a voltage and surge protector designed toprovide filtered and protected electrical power to the cart 11, therebyavoiding placement of a power transformer and other auxiliary powercomponents in the cart 11, resulting in a smaller, more moveable cart11.

The tower 30 may also include support equipment for the sensors deployedthroughout the robotic system 10. For example, the tower 30 may includeoptoelectronics equipment for detecting, receiving, and processing datareceived from the optical sensors or cameras throughout the roboticsystem 10. In combination with the control system, such optoelectronicsequipment may be used to generate real-time images for display in anynumber of consoles deployed throughout the system, including in thetower 30. Similarly, the tower 30 may also include an electronicsubsystem for receiving and processing signals received from deployedelectromagnetic (EM) sensors. The tower 30 may also be used to house andposition an EM field generator for detection by EM sensors in or on themedical instrument.

The tower 30 may also include a console 31 in addition to other consolesavailable in the rest of the system, e.g., console mounted on top of thecart. The console 31 may include a user interface and a display screen,such as a touchscreen, for the physician operator. Consoles in thesystem 10 are generally designed to provide both robotic controls aswell as preoperative and real-time information of the procedure, such asnavigational and localization information of the endoscope 13. When theconsole 31 is not the only console available to the physician, it may beused by a second operator, such as a nurse, to monitor the health orvitals of the patient and the operation of the system 10, as well as toprovide procedure-specific data, such as navigational and localizationinformation. In other embodiments, the console 30 is housed in a bodythat is separate from the tower 30.

The tower 30 may be coupled to the cart 11 and endoscope 13 through oneor more cables or connections (not shown). In some embodiments, thesupport functionality from the tower 30 may be provided through a singlecable to the cart 11, simplifying and de-cluttering the operating room.In other embodiments, specific functionality may be coupled in separatecabling and connections. For example, while power may be providedthrough a single power cable to the cart 11, the support for controls,optics, fluidics, and/or navigation may be provided through a separatecable.

FIG. 2 provides a detailed illustration of an embodiment of the cart 11from the cart-based robotically-enabled system shown in FIG. 1. The cart11 generally includes an elongated support structure 14 (often referredto as a “column”), a cart base 15, and a console 16 at the top of thecolumn 14. The column 14 may include one or more carriages, such as acarriage 17 (alternatively “arm support”) for supporting the deploymentof one or more robotic arms 12 (three shown in FIG. 2). The carriage 17may include individually configurable arm mounts that rotate along aperpendicular axis to adjust the base of the robotic arms 12 for betterpositioning relative to the patient. The carriage 17 also includes acarriage interface 19 that allows the carriage 17 to verticallytranslate along the column 14.

The carriage interface 19 is connected to the column 14 through slots,such as slot 20, that are positioned on opposite sides of the column 14to guide the vertical translation of the carriage 17. The slot 20contains a vertical translation interface to position and hold thecarriage 17 at various vertical heights relative to the cart base 15.Vertical translation of the carriage 17 allows the cart 11 to adjust thereach of the robotic arms 12 to meet a variety of table heights, patientsizes, and physician preferences. Similarly, the individuallyconfigurable arm mounts on the carriage 17 allow the robotic arm base 21of the robotic arms 12 to be angled in a variety of configurations.

In some embodiments, the slot 20 may be supplemented with slot coversthat are flush and parallel to the slot surface to prevent dirt andfluid ingress into the internal chambers of the column 14 and thevertical translation interface as the carriage 17 vertically translates.The slot covers may be deployed through pairs of spring spoolspositioned near the vertical top and bottom of the slot 20. The coversare coiled within the spools until deployed to extend and retract fromtheir coiled state as the carriage 17 vertically translates up and down.The spring-loading of the spools provides force to retract the coverinto a spool when the carriage 17 translates towards the spool, whilealso maintaining a tight seal when the carriage 17 translates away fromthe spool. The covers may be connected to the carriage 17 using, forexample, brackets in the carriage interface 19 to ensure properextension and retraction of the cover as the carriage 17 translates.

The column 14 may internally comprise mechanisms, such as gears andmotors, that are designed to use a vertically aligned lead screw totranslate the carriage 17 in a mechanized fashion in response to controlsignals generated in response to user inputs, e.g., inputs from theconsole 16.

The robotic arms 12 may generally comprise robotic arm bases 21 and endeffectors 22, separated by a series of linkages 23 that are connected bya series of joints 24, each joint comprising an independent actuator,each actuator comprising an independently controllable motor. Eachindependently controllable joint represents an independent degree offreedom available to the robotic arm 12. Each of the robotic arms 12 mayhave seven joints, and thus provide seven degrees of freedom. Amultitude of joints result in a multitude of degrees of freedom,allowing for “redundant” degrees of freedom. Having redundant degrees offreedom allows the robotic arms 12 to position their respective endeffectors 22 at a specific position, orientation, and trajectory inspace using different linkage positions and joint angles. This allowsfor the system to position and direct a medical instrument from adesired point in space while allowing the physician to move the armjoints into a clinically advantageous position away from the patient tocreate greater access, while avoiding arm collisions.

The cart base 15 balances the weight of the column 14, carriage 17, androbotic arms 12 over the floor. Accordingly, the cart base 15 housesheavier components, such as electronics, motors, power supply, as wellas components that either enable movement and/or immobilize the cart 11.For example, the cart base 15 includes rollable wheel-shaped casters 25that allow for the cart 11 to easily move around the room prior to aprocedure. After reaching the appropriate position, the casters 25 maybe immobilized using wheel locks to hold the cart 11 in place during theprocedure.

Positioned at the vertical end of the column 14, the console 16 allowsfor both a user interface for receiving user input and a display screen(or a dual-purpose device such as, for example, a touchscreen 26) toprovide the physician user with both preoperative and intraoperativedata. Potential preoperative data on the touchscreen 26 may includepreoperative plans, navigation and mapping data derived frompreoperative computerized tomography (CT) scans, and/or notes frompreoperative patient interviews. Intraoperative data on display mayinclude optical information provided from the tool, sensor andcoordinate information from sensors, as well as vital patientstatistics, such as respiration, heart rate, and/or pulse. The console16 may be positioned and tilted to allow a physician to access theconsole 16 from the side of the column 14 opposite the carriage 17. Fromthis position, the physician may view the console 16, robotic arms 12,and patient while operating the console 16 from behind the cart 11. Asshown, the console 16 also includes a handle 27 to assist withmaneuvering and stabilizing the cart 11.

FIG. 3 illustrates an embodiment of a robotically-enabled system 10arranged for ureteroscopy. In a ureteroscopic procedure, the cart 11 maybe positioned to deliver a ureteroscope 32, a procedure-specificendoscope designed to traverse a patient's urethra and ureter, to thelower abdominal area of the patient. In a ureteroscopy, it may bedesirable for the ureteroscope 32 to be directly aligned with thepatient's urethra to reduce friction and forces on the sensitive anatomyin the area. As shown, the cart 11 may be aligned at the foot of thetable to allow the robotic arms 12 to position the ureteroscope 32 fordirect linear access to the patient's urethra. From the foot of thetable, the robotic arms 12 may insert the ureteroscope 32 along thevirtual rail 33 directly into the patient's lower abdomen through theurethra.

After insertion into the urethra, using similar control techniques as inbronchoscopy, the ureteroscope 32 may be navigated into the bladder,ureters, and/or kidneys for diagnostic and/or therapeutic applications.For example, the ureteroscope 32 may be directed into the ureter andkidneys to break up kidney stone build up using a laser or ultrasoniclithotripsy device deployed down the working channel of the ureteroscope32. After lithotripsy is complete, the resulting stone fragments may beremoved using baskets deployed down the ureteroscope 32.

FIG. 4 illustrates an embodiment of a robotically-enabled system 10similarly arranged for a vascular procedure. In a vascular procedure,the system 10 may be configured such that the cart 11 may deliver amedical instrument 34, such as a steerable catheter, to an access pointin the femoral artery in the patient's leg. The femoral artery presentsboth a larger diameter for navigation as well as a relatively lesscircuitous and tortuous path to the patient's heart, which simplifiesnavigation. As in a ureteroscopic procedure, the cart 11 may bepositioned towards the patient's legs and lower abdomen to allow therobotic arms 12 to provide a virtual rail 35 with direct linear accessto the femoral artery access point in the patient's thigh/hip region.After insertion into the artery, the medical instrument 34 may bedirected and inserted by translating the instrument drivers 28.Alternatively, the cart may be positioned around the patient's upperabdomen in order to reach alternative vascular access points, such as,for example, the carotid and brachial arteries near the shoulder andwrist.

B. Robotic System—Table.

Embodiments of the robotically-enabled medical system may alsoincorporate the patient's table. Incorporation of the table reduces theamount of capital equipment within the operating room by removing thecart, which allows greater access to the patient. FIG. 5 illustrates anembodiment of such a robotically-enabled system arranged for abronchoscopic procedure. System 36 includes a support structure orcolumn 37 for supporting platform 38 (shown as a “table” or “bed”) overthe floor. Much like in the cart-based systems, the end effectors of therobotic arms 39 of the system 36 comprise instrument drivers 42 that aredesigned to manipulate an elongated medical instrument, such as abronchoscope 40 in FIG. 5, through or along a virtual rail 41 formedfrom the linear alignment of the instrument drivers 42. In practice, aC-arm for providing fluoroscopic imaging may be positioned over thepatient's upper abdominal area by placing the emitter and detectoraround the table 38.

FIG. 6 provides an alternative view of the system 36 without the patientand medical instrument for discussion purposes. As shown, the column 37may include one or more carriages 43 shown as ring-shaped in the system36, from which the one or more robotic arms 39 may be based. Thecarriages 43 may translate along a vertical column interface 44 thatruns the length of the column 37 to provide different vantage pointsfrom which the robotic arms 39 may be positioned to reach the patient.The carriage(s) 43 may rotate around the column 37 using a mechanicalmotor positioned within the column 37 to allow the robotic arms 39 tohave access to multiples sides of the table 38, such as, for example,both sides of the patient. In embodiments with multiple carriages, thecarriages may be individually positioned on the column and may translateand/or rotate independently of the other carriages. While the carriages43 need not surround the column 37 or even be circular, the ring-shapeas shown facilitates rotation of the carriages 43 around the column 37while maintaining structural balance. Rotation and translation of thecarriages 43 allows the system 36 to align the medical instruments, suchas endoscopes and laparoscopes, into different access points on thepatient. In other embodiments (not shown), the system 36 can include apatient table or bed with adjustable arm supports in the form of bars orrails extending alongside it. One or more robotic arms 39 (e.g., via ashoulder with an elbow joint) can be attached to the adjustable armsupports, which can be vertically adjusted. By providing verticaladjustment, the robotic arms 39 are advantageously capable of beingstowed compactly beneath the patient table or bed, and subsequentlyraised during a procedure.

The robotic arms 39 may be mounted on the carriages 43 through a set ofarm mounts 45 comprising a series of joints that may individually rotateand/or telescopically extend to provide additional configurability tothe robotic arms 39. Additionally, the arm mounts 45 may be positionedon the carriages 43 such that, when the carriages 43 are appropriatelyrotated, the arm mounts 45 may be positioned on either the same side ofthe table 38 (as shown in FIG. 6), on opposite sides of the table 38 (asshown in FIG. 9), or on adjacent sides of the table 38 (not shown).

The column 37 structurally provides support for the table 38, and a pathfor vertical translation of the carriages 43. Internally, the column 37may be equipped with lead screws for guiding vertical translation of thecarriages, and motors to mechanize the translation of the carriages 43based the lead screws. The column 37 may also convey power and controlsignals to the carriages 43 and the robotic arms 39 mounted thereon.

The table base 46 serves a similar function as the cart base 15 in thecart 11 shown in FIG. 2, housing heavier components to balance thetable/bed 38, the column 37, the carriages 43, and the robotic arms 39.The table base 46 may also incorporate rigid casters to providestability during procedures. Deployed from the bottom of the table base46, the casters may extend in opposite directions on both sides of thebase 46 and retract when the system 36 needs to be moved.

With continued reference to FIG. 6, the system 36 may also include atower (not shown) that divides the functionality of the system 36between the table and the tower to reduce the form factor and bulk ofthe table. As in earlier disclosed embodiments, the tower may provide avariety of support functionalities to the table, such as processing,computing, and control capabilities, power, fluidics, and/or optical andsensor processing. The tower may also be movable to be positioned awayfrom the patient to improve physician access and de-clutter theoperating room. Additionally, placing components in the tower allows formore storage space in the table base 46 for potential stowage of therobotic arms 39. The tower may also include a master controller orconsole that provides both a user interface for user input, such askeyboard and/or pendant, as well as a display screen (or touchscreen)for preoperative and intraoperative information, such as real-timeimaging, navigation, and tracking information. In some embodiments, thetower may also contain holders for gas tanks to be used forinsufflation.

In some embodiments, a table base may stow and store the robotic armswhen not in use. FIG. 7 illustrates a system 47 that stows robotic armsin an embodiment of the table-based system. In the system 47, carriages48 may be vertically translated into base 49 to stow robotic arms 50,arm mounts 51, and the carriages 48 within the base 49. Base covers 52may be translated and retracted open to deploy the carriages 48, armmounts 51, and robotic arms 50 around column 53, and closed to stow toprotect them when not in use. The base covers 52 may be sealed with amembrane 54 along the edges of its opening to prevent dirt and fluidingress when closed.

FIG. 8 illustrates an embodiment of a robotically-enabled table-basedsystem configured for a ureteroscopic procedure. In a ureteroscopy, thetable 38 may include a swivel portion 55 for positioning a patientoff-angle from the column 37 and table base 46. The swivel portion 55may rotate or pivot around a pivot point (e.g., located below thepatient's head) in order to position the bottom portion of the swivelportion 55 away from the column 37. For example, the pivoting of theswivel portion 55 allows a C-arm (not shown) to be positioned over thepatient's lower abdomen without competing for space with the column (notshown) below table 38. By rotating the carriage 35 (not shown) aroundthe column 37, the robotic arms 39 may directly insert a ureteroscope 56along a virtual rail 57 into the patient's groin area to reach theurethra. In a ureteroscopy, stirrups 58 may also be fixed to the swivelportion 55 of the table 38 to support the position of the patient's legsduring the procedure and allow clear access to the patient's groin area.

In a laparoscopic procedure, through small incision(s) in the patient'sabdominal wall, minimally invasive instruments may be inserted into thepatient's anatomy. In some embodiments, the minimally invasiveinstruments comprise an elongated rigid member, such as a shaft, whichis used to access anatomy within the patient. After inflation of thepatient's abdominal cavity, the instruments may be directed to performsurgical or medical tasks, such as grasping, cutting, ablating,suturing, etc. In some embodiments, the instruments can comprise ascope, such as a laparoscope. FIG. 9 illustrates an embodiment of arobotically-enabled table-based system configured for a laparoscopicprocedure. As shown in FIG. 9, the carriages 43 of the system 36 may berotated and vertically adjusted to position pairs of the robotic arms 39on opposite sides of the table 38, such that instrument 59 may bepositioned using the arm mounts 45 to be passed through minimalincisions on both sides of the patient to reach his/her abdominalcavity.

To accommodate laparoscopic procedures, the robotically-enabled tablesystem may also tilt the platform to a desired angle. FIG. 10illustrates an embodiment of the robotically-enabled medical system withpitch or tilt adjustment. As shown in FIG. 10, the system 36 mayaccommodate tilt of the table 38 to position one portion of the table ata greater distance from the floor than the other. Additionally, the armmounts 45 may rotate to match the tilt such that the robotic arms 39maintain the same planar relationship with the table 38. To accommodatesteeper angles, the column 37 may also include telescoping portions 60that allow vertical extension of the column 37 to keep the table 38 fromtouching the floor or colliding with the table base 46.

FIG. 11 provides a detailed illustration of the interface between thetable 38 and the column 37. Pitch rotation mechanism 61 may beconfigured to alter the pitch angle of the table 38 relative to thecolumn 37 in multiple degrees of freedom. The pitch rotation mechanism61 may be enabled by the positioning of orthogonal axes 1, 2 at thecolumn-table interface, each axis actuated by a separate motor 3, 4responsive to an electrical pitch angle command. Rotation along onescrew 5 would enable tilt adjustments in one axis 1, while rotationalong the other screw 6 would enable tilt adjustments along the otheraxis 2. In some embodiments, a ball joint can be used to alter the pitchangle of the table 38 relative to the column 37 in multiple degrees offreedom.

For example, pitch adjustments are particularly useful when trying toposition the table in a Trendelenburg position, i.e., position thepatient's lower abdomen at a higher position from the floor than thepatient's upper abdomen, for lower abdominal surgery. The Trendelenburgposition causes the patient's internal organs to slide towards his/herupper abdomen through the force of gravity, clearing out the abdominalcavity for minimally invasive tools to enter and perform lower abdominalsurgical or medical procedures, such as laparoscopic prostatectomy.

FIGS. 12 and 13 illustrate isometric and end views of an alternativeembodiment of a table-based surgical robotics system 100. The surgicalrobotics system 100 includes one or more adjustable arm supports 105that can be configured to support one or more robotic arms (see, forexample, FIG. 14) relative to a table 101. In the illustratedembodiment, a single adjustable arm support 105 is shown, though anadditional arm support can be provided on an opposite side of the table101. The adjustable arm support 105 can be configured so that it canmove relative to the table 101 to adjust and/or vary the position of theadjustable arm support 105 and/or any robotic arms mounted theretorelative to the table 101. For example, the adjustable arm support 105may be adjusted one or more degrees of freedom relative to the table101. The adjustable arm support 105 provides high versatility to thesystem 100, including the ability to easily stow the one or moreadjustable arm supports 105 and any robotics arms attached theretobeneath the table 101. The adjustable arm support 105 can be elevatedfrom the stowed position to a position below an upper surface of thetable 101. In other embodiments, the adjustable arm support 105 can beelevated from the stowed position to a position above an upper surfaceof the table 101.

The adjustable arm support 105 can provide several degrees of freedom,including lift, lateral translation, tilt, etc. In the illustratedembodiment of FIGS. 12 and 13, the arm support 105 is configured withfour degrees of freedom, which are illustrated with arrows in FIG. 12. Afirst degree of freedom allows for adjustment of the adjustable armsupport 105 in the z-direction (“Z-lift”). For example, the adjustablearm support 105 can include a carriage 109 configured to move up or downalong or relative to a column 102 supporting the table 101. A seconddegree of freedom can allow the adjustable arm support 105 to tilt. Forexample, the adjustable arm support 105 can include a rotary joint,which can allow the adjustable arm support 105 to be aligned with thebed in a Trendelenburg position. A third degree of freedom can allow theadjustable arm support 105 to “pivot up,” which can be used to adjust adistance between a side of the table 101 and the adjustable arm support105. A fourth degree of freedom can permit translation of the adjustablearm support 105 along a longitudinal length of the table.

The surgical robotics system 100 in FIGS. 12 and 13 can comprise a tablesupported by a column 102 that is mounted to a base 103. The base 103and the column 102 support the table 101 relative to a support surface.A floor axis 131 and a support axis 133 are shown in FIG. 13.

The adjustable arm support 105 can be mounted to the column 102. Inother embodiments, the arm support 105 can be mounted to the table 101or base 103. The adjustable arm support 105 can include a carriage 109,a bar or rail connector 111 and a bar or rail 107. In some embodiments,one or more robotic arms mounted to the rail 107 can translate and moverelative to one another.

The carriage 109 can be attached to the column 102 by a first joint 113,which allows the carriage 109 to move relative to the column 102 (e.g.,such as up and down a first or vertical axis 123). The first joint 113can provide the first degree of freedom (Z-lift) to the adjustable armsupport 105. The adjustable arm support 105 can include a second joint115, which provides the second degree of freedom (tilt) for theadjustable arm support 105. The adjustable arm support 105 can include athird joint 117, which can provide the third degree of freedom (“pivotup”) for the adjustable arm support 105. An additional joint 119 (shownin FIG. 13) can be provided that mechanically constrains the third joint117 to maintain an orientation of the rail 107 as the rail connector 111is rotated about a third axis 127. The adjustable arm support 105 caninclude a fourth joint 121, which can provide a fourth degree of freedom(translation) for the adjustable arm support 105 along a fourth axis129.

FIG. 14 illustrates an end view of the surgical robotics system 140Awith two adjustable arm supports 105A, 105B mounted on opposite sides ofa table 101. A first robotic arm 142A is attached to the bar or rail107A of the first adjustable arm support 105B. The first robotic arm142A includes a base 144A attached to the rail 107A. The distal end ofthe first robotic arm 142A includes an instrument drive mechanism 146Athat can attach to one or more robotic medical instruments or tools.Similarly, the second robotic arm 142B includes a base 144B attached tothe rail 107B. The distal end of the second robotic arm 142B includes aninstrument drive mechanism 146B. The instrument drive mechanism 146B canbe configured to attach to one or more robotic medical instruments ortools.

In some embodiments, one or more of the robotic arms 142A, 142Bcomprises an arm with seven or more degrees of freedom. In someembodiments, one or more of the robotic arms 142A, 142B can includeeight degrees of freedom, including an insertion axis (1-degree offreedom including insertion), a wrist (3-degrees of freedom includingwrist pitch, yaw and roll), an elbow (1-degree of freedom includingelbow pitch), a shoulder (2-degrees of freedom including shoulder pitchand yaw), and base 144A, 144B (1-degree of freedom includingtranslation). In some embodiments, the insertion degree of freedom canbe provided by the robotic arm 142A, 142B, while in other embodiments,the instrument itself provides insertion via an instrument-basedinsertion architecture.

C. Instrument Driver & Interface.

The end effectors of the system's robotic arms may comprise (i) aninstrument driver (alternatively referred to as “instrument drivemechanism” or “instrument device manipulator”) that incorporateselectro-mechanical means for actuating the medical instrument and (ii) aremovable or detachable medical instrument, which may be devoid of anyelectro-mechanical components, such as motors. This dichotomy may bedriven by the need to sterilize medical instruments used in medicalprocedures, and the inability to adequately sterilize expensive capitalequipment due to their intricate mechanical assemblies and sensitiveelectronics. Accordingly, the medical instruments may be designed to bedetached, removed, and interchanged from the instrument driver (and thusthe system) for individual sterilization or disposal by the physician orthe physician's staff. In contrast, the instrument drivers need not bechanged or sterilized, and may be draped for protection.

FIG. 15 illustrates an example instrument driver. Positioned at thedistal end of a robotic arm, instrument driver 62 comprises one or moredrive units 63 arranged with parallel axes to provide controlled torqueto a medical instrument via drive shafts 64. Each drive unit 63comprises an individual drive shaft 64 for interacting with theinstrument, a gear head 65 for converting the motor shaft rotation to adesired torque, a motor 66 for generating the drive torque, an encoder67 to measure the speed of the motor shaft and provide feedback to thecontrol circuitry, and control circuitry 68 for receiving controlsignals and actuating the drive unit. Each drive unit 63 beingindependently controlled and motorized, the instrument driver 62 mayprovide multiple (e.g., four as shown in FIG. 15) independent driveoutputs to the medical instrument. In operation, the control circuitry68 would receive a control signal, transmit a motor signal to the motor66, compare the resulting motor speed as measured by the encoder 67 withthe desired speed, and modulate the motor signal to generate the desiredtorque.

For procedures that require a sterile environment, the robotic systemmay incorporate a drive interface, such as a sterile adapter connectedto a sterile drape, that sits between the instrument driver and themedical instrument. The chief purpose of the sterile adapter is totransfer angular motion from the drive shafts of the instrument driverto the drive inputs of the instrument while maintaining physicalseparation, and thus sterility, between the drive shafts and driveinputs. Accordingly, an example sterile adapter may comprise a series ofrotational inputs and outputs intended to be mated with the drive shaftsof the instrument driver and drive inputs on the instrument. Connectedto the sterile adapter, the sterile drape, comprised of a thin, flexiblematerial such as transparent or translucent plastic, is designed tocover the capital equipment, such as the instrument driver, robotic arm,and cart (in a cart-based system) or table (in a table-based system).Use of the drape would allow the capital equipment to be positionedproximate to the patient while still being located in an area notrequiring sterilization (i.e., non-sterile field). On the other side ofthe sterile drape, the medical instrument may interface with the patientin an area requiring sterilization (i.e., sterile field).

D. Medical Instrument.

FIG. 16 illustrates an example medical instrument with a pairedinstrument driver. Like other instruments designed for use with arobotic system, medical instrument 70 comprises an elongated shaft 71(or elongate body) and an instrument base 72. The instrument base 72,also referred to as an “instrument handle” due to its intended designfor manual interaction by the physician, may generally compriserotatable drive inputs 73, e.g., receptacles, pulleys or spools, thatare designed to be mated with drive outputs 74 that extend through adrive interface on instrument driver 75 at the distal end of robotic arm76. When physically connected, latched, and/or coupled, the mated driveinputs 73 of the instrument base 72 may share axes of rotation with thedrive outputs 74 in the instrument driver 75 to allow the transfer oftorque from the drive outputs 74 to the drive inputs 73. In someembodiments, the drive outputs 74 may comprise splines that are designedto mate with receptacles on the drive inputs 73.

The elongated shaft 71 is designed to be delivered through either ananatomical opening or lumen, e.g., as in endoscopy, or a minimallyinvasive incision, e.g., as in laparoscopy. The elongated shaft 71 maybe either flexible (e.g., having properties similar to an endoscope) orrigid (e.g., having properties similar to a laparoscope) or contain acustomized combination of both flexible and rigid portions. Whendesigned for laparoscopy, the distal end of a rigid elongated shaft maybe connected to an end effector extending from a jointed wrist formedfrom a clevis with at least one degree of freedom and a surgical tool ormedical instrument, such as, for example, a grasper or scissors, thatmay be actuated based on force from the tendons as the drive inputsrotate in response to torque received from the drive outputs 74 of theinstrument driver 75. When designed for endoscopy, the distal end of aflexible elongated shaft may include a steerable or controllable bendingsection that may be articulated and bent based on torque received fromthe drive outputs 74 of the instrument driver 75.

Torque from the instrument driver 75 is transmitted down the elongatedshaft 71 using tendons along the elongated shaft 71. These individualtendons, such as pull wires, may be individually anchored to individualdrive inputs 73 within the instrument handle 72. From the handle 72, thetendons are directed down one or more pull lumens along the elongatedshaft 71 and anchored at the distal portion of the elongated shaft 71,or in the wrist at the distal portion of the elongated shaft. During asurgical procedure, such as a laparoscopic, endoscopic or hybridprocedure, these tendons may be coupled to a distally mounted endeffector, such as a wrist, grasper, or scissor. Under such anarrangement, torque exerted on drive inputs 73 would transfer tension tothe tendon, thereby causing the end effector to actuate in some way. Insome embodiments, during a surgical procedure, the tendon may cause ajoint to rotate about an axis, thereby causing the end effector to movein one direction or another. Alternatively, the tendon may be connectedto one or more jaws of a grasper at the distal end of the elongatedshaft 71, where tension from the tendon causes the grasper to close.

In endoscopy, the tendons may be coupled to a bending or articulatingsection positioned along the elongated shaft 71 (e.g., at the distalend) via adhesive, control ring, or other mechanical fixation. Whenfixedly attached to the distal end of a bending section, torque exertedon the drive inputs 73 would be transmitted down the tendons, causingthe softer, bending section (sometimes referred to as the articulablesection or region) to bend or articulate. Along the non-bendingsections, it may be advantageous to spiral or helix the individual pulllumens that direct the individual tendons along (or inside) the walls ofthe endoscope shaft to balance the radial forces that result fromtension in the pull wires. The angle of the spiraling and/or spacingtherebetween may be altered or engineered for specific purposes, whereintighter spiraling exhibits lesser shaft compression under load forces,while lower amounts of spiraling results in greater shaft compressionunder load forces, but limits bending. On the other end of the spectrum,the pull lumens may be directed parallel to the longitudinal axis of theelongated shaft 71 to allow for controlled articulation in the desiredbending or articulable sections.

In endoscopy, the elongated shaft 71 houses a number of components toassist with the robotic procedure. The shaft 71 may comprise a workingchannel for deploying surgical tools (or medical instruments),irrigation, and/or aspiration to the operative region at the distal endof the shaft 71. The shaft 71 may also accommodate wires and/or opticalfibers to transfer signals to/from an optical assembly at the distaltip, which may include an optical camera. The shaft 71 may alsoaccommodate optical fibers to carry light from proximally-located lightsources, such as light emitting diodes, to the distal end of the shaft71.

At the distal end of the instrument 70, the distal tip may also comprisethe opening of a working channel for delivering tools for diagnosticand/or therapy, irrigation, and aspiration to an operative site. Thedistal tip may also include a port for a camera, such as a fiberscope ora digital camera, to capture images of an internal anatomical space.Relatedly, the distal tip may also include ports for light sources forilluminating the anatomical space when using the camera.

In the example of FIG. 16, the drive shaft axes, and thus the driveinput axes, are orthogonal to the axis of the elongated shaft 71. Thisarrangement, however, complicates roll capabilities for the elongatedshaft 71. Rolling the elongated shaft 71 along its axis while keepingthe drive inputs 73 static results in undesirable tangling of thetendons as they extend off the drive inputs 73 and enter pull lumenswithin the elongated shaft 71. The resulting entanglement of suchtendons may disrupt any control algorithms intended to predict movementof the flexible elongated shaft 71 during an endoscopic procedure.

FIG. 17 illustrates an alternative design for an instrument driver andinstrument where the axes of the drive units are parallel to the axis ofthe elongated shaft of the instrument. As shown, a circular instrumentdriver 80 comprises four drive units with their drive outputs 81 alignedin parallel at the end of a robotic arm 82. The drive units, and theirrespective drive outputs 81, are housed in a rotational assembly 83 ofthe instrument driver 80 that is driven by one of the drive units withinthe assembly 83. In response to torque provided by the rotational driveunit, the rotational assembly 83 rotates along a circular bearing thatconnects the rotational assembly 83 to the non-rotational portion 84 ofthe instrument driver 80. Power and controls signals may be communicatedfrom the non-rotational portion 84 of the instrument driver 80 to therotational assembly 83 through electrical contacts that may bemaintained through rotation by a brushed slip ring connection (notshown). In other embodiments, the rotational assembly 83 may beresponsive to a separate drive unit that is integrated into thenon-rotatable portion 84, and thus not in parallel to the other driveunits. The rotational mechanism 83 allows the instrument driver 80 torotate the drive units, and their respective drive outputs 81, as asingle unit around an instrument driver axis 85.

Like earlier disclosed embodiments, an instrument 86 may comprise anelongated shaft portion 88 and an instrument base 87 (shown with atransparent external skin for discussion purposes) comprising aplurality of drive inputs 89 (such as receptacles, pulleys, and spools)that are configured to receive the drive outputs 81 in the instrumentdriver 80. Unlike prior disclosed embodiments, the instrument shaft 88extends from the center of the instrument base 87 with an axissubstantially parallel to the axes of the drive inputs 89, rather thanorthogonal as in the design of FIG. 16.

When coupled to the rotational assembly 83 of the instrument driver 80,the medical instrument 86, comprising instrument base 87 and instrumentshaft 88, rotates in combination with the rotational assembly 83 aboutthe instrument driver axis 85. Since the instrument shaft 88 ispositioned at the center of instrument base 87, the instrument shaft 88is coaxial with instrument driver axis 85 when attached. Thus, rotationof the rotational assembly 83 causes the instrument shaft 88 to rotateabout its own longitudinal axis. Moreover, as the instrument base 87rotates with the instrument shaft 88, any tendons connected to the driveinputs 89 in the instrument base 87 are not tangled during rotation.Accordingly, the parallelism of the axes of the drive outputs 81, driveinputs 89, and instrument shaft 88 allows for the shaft rotation withouttangling any control tendons.

FIG. 18 illustrates an instrument having an instrument based insertionarchitecture in accordance with some embodiments. The instrument 150 canbe coupled to any of the instrument drivers discussed above. Theinstrument 150 comprises an elongated shaft 152, an end effector 162connected to the shaft 152, and a handle 170 coupled to the shaft 152.The elongated shaft 152 comprises a tubular member having a proximalportion 154 and a distal portion 156. The elongated shaft 152 comprisesone or more channels or grooves 158 along its outer surface. The grooves158 are configured to receive one or more wires or cables 180therethrough. One or more cables 180 thus run along an outer surface ofthe elongated shaft 152. In other embodiments, cables 180 can also runthrough the elongated shaft 152. Manipulation of the one or more cables180 (e.g., via an instrument driver) results in actuation of the endeffector 162.

The instrument handle 170, which may also be referred to as aninstrument base, may generally comprise an attachment interface 172having one or more mechanical inputs 174, e.g., receptacles, pulleys orspools, that are designed to be reciprocally mated with one or moretorque couplers on an attachment surface of an instrument driver.

In some embodiments, the instrument 150 comprises a series of pulleys orcables that enable the elongated shaft 152 to translate relative to thehandle 170. In other words, the instrument 150 itself comprises aninstrument-based insertion architecture that accommodates insertion ofthe instrument, thereby minimizing the reliance on a robot arm toprovide insertion of the instrument 150. In other embodiments, a roboticarm can be largely responsible for instrument insertion.

E. Controller.

Any of the robotic systems described herein can include an input deviceor controller for manipulating an instrument attached to a robotic arm.In some embodiments, the controller can be coupled (e.g.,communicatively, electronically, electrically, wirelessly and/ormechanically) with an instrument such that manipulation of thecontroller causes a corresponding manipulation of the instrument e.g.,via master slave control.

FIG. 19 is a perspective view of an embodiment of a controller 182. Inthe present embodiment, the controller 182 comprises a hybrid controllerthat can have both impedance and admittance control. In otherembodiments, the controller 182 can utilize just impedance or passivecontrol. In other embodiments, the controller 182 can utilize justadmittance control. By being a hybrid controller, the controller 182advantageously can have a lower perceived inertia while in use.

In the illustrated embodiment, the controller 182 is configured to allowmanipulation of two medical instruments, and includes two handles 184.Each of the handles 184 is connected to a gimbal 186. Each gimbal 186 isconnected to a positioning platform 188.

As shown in FIG. 19, each positioning platform 188 includes a SCARA arm(selective compliance assembly robot arm) 198 coupled to a column 194 bya prismatic joint 196. The prismatic joints 196 are configured totranslate along the column 194 (e.g., along rails 197) to allow each ofthe handles 184 to be translated in the z-direction, providing a firstdegree of freedom. The SCARA arm 198 is configured to allow motion ofthe handle 184 in an x-y plane, providing two additional degrees offreedom.

In some embodiments, one or more load cells are positioned in thecontroller. For example, in some embodiments, a load cell (not shown) ispositioned in the body of each of the gimbals 186. By providing a loadcell, portions of the controller 182 are capable of operating underadmittance control, thereby advantageously reducing the perceivedinertia of the controller while in use. In some embodiments, thepositioning platform 188 is configured for admittance control, while thegimbal 186 is configured for impedance control. In other embodiments,the gimbal 186 is configured for admittance control, while thepositioning platform 188 is configured for impedance control.Accordingly, for some embodiments, the translational or positionaldegrees of freedom of the positioning platform 188 can rely onadmittance control, while the rotational degrees of freedom of thegimbal 186 rely on impedance control.

F. Navigation and Control.

Traditional endoscopy may involve the use of fluoroscopy (e.g., as maybe delivered through a C-arm) and other forms of radiation-based imagingmodalities to provide endoluminal guidance to an operator physician. Incontrast, the robotic systems contemplated by this disclosure canprovide for non-radiation-based navigational and localization means toreduce physician exposure to radiation and reduce the amount ofequipment within the operating room. As used herein, the term“localization” may refer to determining and/or monitoring the positionof objects in a reference coordinate system. Technologies such aspreoperative mapping, computer vision, real-time EM tracking, and robotcommand data may be used individually or in combination to achieve aradiation-free operating environment. In other cases, whereradiation-based imaging modalities are still used, the preoperativemapping, computer vision, real-time EM tracking, and robot command datamay be used individually or in combination to improve upon theinformation obtained solely through radiation-based imaging modalities.

FIG. 20 is a block diagram illustrating a localization system 90 thatestimates a location of one or more elements of the robotic system, suchas the location of the instrument, in accordance to an exampleembodiment. The localization system 90 may be a set of one or morecomputer devices configured to execute one or more instructions. Thecomputer devices may be embodied by a processor (or processors) andcomputer-readable memory in one or more components discussed above. Byway of example and not limitation, the computer devices may be in thetower 30 shown in FIG. 1, the cart 11 shown in FIGS. 1-4, the beds shownin FIGS. 5-14, etc.

As shown in FIG. 20, the localization system 90 may include alocalization module 95 that processes input data 91-94 to generatelocation data 96 for the distal tip of a medical instrument. Thelocation data 96 may be data or logic that represents a location and/ororientation of the distal end of the instrument relative to a frame ofreference. The frame of reference can be a frame of reference relativeto the anatomy of the patient or to a known object, such as an EM fieldgenerator (see discussion below for the EM field generator).

The various input data 91-94 are now described in greater detail.Preoperative mapping may be accomplished through the use of thecollection of low dose CT scans. Preoperative CT scans are reconstructedinto three-dimensional images, which are visualized, e.g. as “slices” ofa cutaway view of the patient's internal anatomy. When analyzed in theaggregate, image-based models for anatomical cavities, spaces andstructures of the patient's anatomy, such as a patient lung network, maybe generated. Techniques such as center-line geometry may be determinedand approximated from the CT images to develop a three-dimensionalvolume of the patient's anatomy, referred to as model data 91 (alsoreferred to as “preoperative model data” when generated using onlypreoperative CT scans). The use of center-line geometry is discussed inU.S. patent application Ser. No. 14/523,760, the contents of which areherein incorporated in its entirety. Network topological models may alsobe derived from the CT-images, and are particularly appropriate forbronchoscopy.

In some embodiments, the instrument may be equipped with a camera toprovide vision data (or image data) 92. The localization module 95 mayprocess the vision data 92 to enable one or more vision-based (orimage-based) location tracking modules or features. For example, thepreoperative model data 91 may be used in conjunction with the visiondata 92 to enable computer vision-based tracking of the medicalinstrument (e.g., an endoscope or an instrument advance through aworking channel of the endoscope). For example, using the preoperativemodel data 91, the robotic system may generate a library of expectedendoscopic images from the model based on the expected path of travel ofthe endoscope, each image linked to a location within the model.Intraoperatively, this library may be referenced by the robotic systemin order to compare real-time images captured at the camera (e.g., acamera at a distal end of the endoscope) to those in the image libraryto assist localization.

Other computer vision-based tracking techniques use feature tracking todetermine motion of the camera, and thus the endoscope. Some features ofthe localization module 95 may identify circular geometries in thepreoperative model data 91 that correspond to anatomical lumens andtrack the change of those geometries to determine which anatomical lumenwas selected, as well as the relative rotational and/or translationalmotion of the camera. Use of a topological map may further enhancevision-based algorithms or techniques.

Optical flow, another computer vision-based technique, may analyze thedisplacement and translation of image pixels in a video sequence in thevision data 92 to infer camera movement. Examples of optical flowtechniques may include motion detection, object segmentationcalculations, luminance, motion compensated encoding, stereo disparitymeasurement, etc. Through the comparison of multiple frames overmultiple iterations, movement and location of the camera (and thus theendoscope) may be determined.

The localization module 95 may use real-time EM tracking to generate areal-time location of the endoscope in a global coordinate system thatmay be registered to the patient's anatomy, represented by thepreoperative model. In EM tracking, an EM sensor (or tracker) comprisingone or more sensor coils embedded in one or more locations andorientations in a medical instrument (e.g., an endoscopic tool) measuresthe variation in the EM field created by one or more static EM fieldgenerators positioned at a known location. The location informationdetected by the EM sensors is stored as EM data 93. The EM fieldgenerator (or transmitter), may be placed close to the patient to createa low intensity magnetic field that the embedded sensor may detect. Themagnetic field induces small currents in the sensor coils of the EMsensor, which may be analyzed to determine the distance and anglebetween the EM sensor and the EM field generator. These distances andorientations may be intraoperatively “registered” to the patient anatomy(e.g., the preoperative model) in order to determine the geometrictransformation that aligns a single location in the coordinate systemwith a position in the preoperative model of the patient's anatomy. Onceregistered, an embedded EM tracker in one or more positions of themedical instrument (e.g., the distal tip of an endoscope) may providereal-time indications of the progression of the medical instrumentthrough the patient's anatomy.

Robotic command and kinematics data 94 may also be used by thelocalization module 95 to provide localization data 96 for the roboticsystem. Device pitch and yaw resulting from articulation commands may bedetermined during preoperative calibration. Intraoperatively, thesecalibration measurements may be used in combination with known insertiondepth information to estimate the position of the instrument.Alternatively, these calculations may be analyzed in combination withEM, vision, and/or topological modeling to estimate the position of themedical instrument within the network.

As FIG. 20 shows, a number of other input data can be used by thelocalization module 95. For example, although not shown in FIG. 20, aninstrument utilizing shape-sensing fiber can provide shape data that thelocalization module 95 can use to determine the location and shape ofthe instrument.

The localization module 95 may use the input data 91-94 incombination(s). In some cases, such a combination may use aprobabilistic approach where the localization module 95 assigns aconfidence weight to the location determined from each of the input data91-94. Thus, where the EM data may not be reliable (as may be the casewhere there is EM interference) the confidence of the locationdetermined by the EM data 93 can be decrease and the localization module95 may rely more heavily on the vision data 92 and/or the roboticcommand and kinematics data 94.

As discussed above, the robotic systems discussed herein may be designedto incorporate a combination of one or more of the technologies above.The robotic system's computer-based control system, based in the tower,bed and/or cart, may store computer program instructions, for example,within a non-transitory computer-readable storage medium such as apersistent magnetic storage drive, solid state drive, or the like, that,upon execution, cause the system to receive and analyze sensor data anduser commands, generate control signals throughout the system, anddisplay the navigational and localization data, such as the position ofthe instrument within the global coordinate system, anatomical map, etc.

2. Functional Indicators for Robotic Medical Systems.

Robotic medical systems can include indicators—such as visual or audibleindicators, among others—that can be configured to communicate orotherwise provide information about the systems to users. Suchindicators can be particularly useful for robotic medical systems thatinclude a plurality of robotically controlled moveable components,although the indicators are also useful in less complex systems as well.The indicators can be configured to provide various functions as will bedescribed below, including, for example, providing state and or identityinformation for the robotic system and/or components thereof. In someembodiments, state information can comprise, for example, a stand bystate, a powered state, an active state, a ready state, an error state(e.g., a fault or collision state), a deployment state, a storage state,an emergency stop state, a motion (or impending motion) state, etc., ofthe robotic system and/or a component of the robotic system (such as arobotic arm, a medical instrument, an instrument driver, or an armsupport). Identity information can comprise, for example, informationthat can be used to identify the robotic system and/or componentsthereof (for example, to distinguish one robotic arm from another or todistinguish one robotic tool from another).

As an initial example, the indicators can be configured to provide orcommunicate state and/or identity information about the system and/orits components. For example, an indicator can be configured tocommunicate that one or more components of the system are about to moveand/or are moving. The indication can serve to notify users in thevicinity of the system about the movement so that unintentional contactbetween the users and the system can be avoided. Thus, in someembodiments, the indicators can be configured to provide informationrelated to a movement state of the system. This can increase safety forthose using this system.

As another example, an indicator can serve to provide identificationinformation for a component of the robotic system. As noted above, arobotic system can include one or more robotic arms. An indicator can beconfigured to provide identification information associated with the oneor more robotic arms. For example, a first robotic arm can be associatedwith an indicator of a first color, while a second robotic arm can beassociated with an indicator of a second color. Users of the system canthen identify the first and second robotic arms by referring to thefirst and second colors. This can facilitate use of the system byproviding a mechanism by which the components of the robotic system canbe identified and referenced. Advantageously, providing suchidentification information on the one or more robotic arms communicatesto a clinician or clinician's assistant information with ease andenhances safety before and during a surgical procedure.

As will be described in more detail below, the indicators canadvantageously be positioned on various components of the roboticsystem. In some embodiments, for example, the indicators can bepositioned on adjustable arm supports and/or on a patient platform ofthe robotic medical system. Other locations for the indicators are alsopossible.

FIGS. 21A and 21B illustrate an embodiment of a robotic system 200 thatmay include one or more indicators 201. In the illustrated embodiment,the indicators 201 comprise light emitting diode (LED) light strips,although, as noted below, other types of indicators (e.g., other typesof visual or audible indicators, etc.) can also be used. For example,other visual indicators can include lasers or moveable colored markers.Further, in the illustrated embodiment, the indicators 201 arepositioned on adjustable arm supports 203 and a patient platform 205 ofthe system 200. The illustrated positions of the indicators 201 areprovided by way of example, not limitation. Further, not all indicators201 need be included in all embodiments. For example, in someembodiments, the indicators 201 can be omitted from the patient platform205 or the adjustable arm supports 203.

The system 200 can be similar in some respects to the systems 100, 140Adescribed above with reference to FIGS. 12-14. For example, theadjustable arm supports 203 can be similar to the adjustable armsupports 105, and the patient platform 205 can be similar to the patientplatform 101 previously described. The patient platform 205 isconfigured to support a patient during a robotic medical procedure. Theadjustable arm supports 203 can be configured so as to be moveable oradjustable relative to the patient platform 205, in a similar manner asdescribed above with reference to the systems of FIGS. 12-14.

In the illustrated embodiment, the adjustable arm supports 203 include arail or bar that can be configured to support one or more robotic arms207. The adjustable arm supports 203 and robotic arms 207 can be movedbetween a wide variety of positions, for example, to facilitate arobotic medical procedure (e.g., to a position as shown in FIG. 21B)and/or to facilitate storage of the adjustable arm supports 203 androbotic arms 207 beneath the patient platform 205 (e.g., as shown inFIG. 21A). As described above with reference to FIGS. 12-14, theadjustable arm supports 203 can be configured for movement in multipledegrees of freedom. For example, the adjustable arm supports 203 canmove in all three spatial directions, including up and down, and enablethe robotic arms 207 that are attached thereto to be stored underneaththe patient platform 205.

As apparent from the preceding description, the robotic medical systems200 can include a plurality of moveable/adjustable robotic components.In view of the high degree of movement, it can become important that thesystem 200 is configured to effectively and efficiently communicatevarious types of information about the system to users. As describedbelow, the indicators 201 described in this section can be configuredfor this and other purposes. For example, during movement of componentsof the system 200, there can be a risk of harm to users of the systemsin a variety of situations. One such situation is the deployment of therobotic arms 207 as they are moved from their stowed position under thepatient platform 205 to a deployed position on either side of thepatient platform 205. Another potentially dangerous situation is theautonomous or remotely controlled movement of the arm supports 203during a procedure, whereby the risk can be particularly pronounced forany sterile users supporting the procedure that are, for example,standing next to the system. As described in more detail below, theindicators 201 described herein can be configured to communicateinformation regarding movement or other states of the various roboticcomponents of the system to nearby users to mitigate the risk of harm orotherwise facilitate a robotic medical procedure. As one example, anindicator 201 can flash or change color to indicate that an associatedrobotic component is about to move. This may provide an indication tousers in the vicinity to keep clear, improving safety in the operatingroom.

These and other features and functions of the indicators 201 and system200 will become more fully apparent from the following sections thatdescribe (A) indicators 201 on arm supports 203, (B) indicators 201 onpatient platforms 205, (C) indicators 201 on towers, and (D) functionsor features that can be provided by the indicators 201. Althoughsections (A) and (B) describe example indicator locations on armsupports 203 and patient platforms 205, other locations for indicators201 are also possible. Further, the indicators 201 can also be used inother types of medical systems that may not include adjustable armsupports 203 or patient platforms 205.

A. Indicators on Arm Supports.

As shown in FIGS. 21A and 21B, in some embodiments, indicators 201 canbe included on each of the adjustable arm supports 203 of the system200. This may be advantageous because it can provide indicators on eachside of the patient platform 205 (if adjustable arm supports 203 areincluded on each side as illustrated) and can provide the indicatorsdirectly on one of the moveable components of the system 200. In theillustrated embodiment, the indicators 201 on the adjustable armsupports 203 comprise one or more lights (e.g., LEDs or LED arrays),while in other embodiments, the indicator/signifier can comprise one ormore audible speakers (see FIG. 26) or a combination of a visual andaudible indicators (e.g., LEDs embedded in the speakers themselves). Theindicators 201 can be used at different periods of a surgical procedure,including during set-up, intraprocedure, or take-down.

In the illustrated embodiment of FIGS. 21A and 21B, the indicator 201 onthe adjustable arm support 203 comprises an LED light strip that ispositioned along one or more side surfaces of the adjustable arm support203. In some embodiments, one or more additional indicators 201 can alsobe provided, alternatively or additionally, on one or more additionalsurfaces of the adjustable arm support 203 as shown, for example, inFIGS. 22A-22D. FIGS. 22A-22D illustrate example indicators 201 on theadjustable arm support 203 (e.g., on the bar or rail of the adjustablearm support 203) according to several embodiments to illustrate certainfeatures of this disclosure.

FIG. 22A is a perspective view of an adjustable arm support 203 thatincludes an indicator 201. In the illustrated embodiment, the indicator201 comprises an LED light strip. The LED light strip can include aplurality of LEDs. The LEDs can be individually addressable such thatthey can be controlled individually. Thus, in some embodiments,different portions or regions of the indicator 201 can be activated(e.g., lit up) or deactivated (e.g., turned on) individually as will bedescribed in more detail below. Further, in some embodiments, the LEDsof the indicator 201 may be configured to light up in different colorsand/or to provide illumination at different intensities. Althoughdescribed as including LEDs, other types of light-based indicators canalso be used. In addition, though not shown in FIG. 22A, speakers and/orother indicators/signifiers may be included with the LEDs.

In the illustrated embodiment, the indicator 201 is positioned on anouter surface 209 of the adjustable arm support 203. The outer surface209 may be a surface of the adjustable arm support 203 that faces awayfrom the patient platform 205. This placement location can provide goodvisibility to users standing on the side of the patient platform 205.Additionally, in the illustrated embodiment of FIG. 22A, the indicator201 extends onto end surfaces 211 of the adjustable arm support 203.Thus, the indicator 201 can “wrap around” the adjustable arm support203. In some embodiments, the indicator 201 extends onto both endsurfaces 211 of the adjustable arm support. In some embodiments,indicators 201 that wraparound multiple surfaces of the adjustable armsupport 203 can be visible to users positioned at different locationsaround the patient platform 205, such as at the head end or foot end ofthe patient platform 205. Although not visible in FIG. 22A, in someembodiments, the indicator 201 can further extend onto an inner surface213, upper surface, and/or lower surface of the adjustable arm support203. Also, although the indicator 201 is illustrated as a continuousstrip in FIG. 22A, this need not be the case in all embodiments, asshown, for example, in the embodiment of FIG. 22B.

FIG. 22B illustrates a perspective view of an additional embodiment ofan adjustable arm support 203 that includes a plurality of discreteindicators 201. In the illustrated embodiment, the indicators 201 areillustrated as light sources, such as LEDs, although other types ofindicators 201 can be used. The individual or discrete indicators 201can be individually addressable such that they can be controlledindividually. Thus, in some embodiments, different indicators 201 can beactivated (e.g., lit up) or deactivated (e.g., turned on) individuallyas will be described in more detail below. Further, in some embodiments,the LEDs of each indicator 201 may be configured to light up indifferent colors. In the illustrated embodiment, the individualindicators 201 are positioned on the outer surface 209 of the adjustablearm support 203. Additionally, indicators 201 are positioned so as toextend onto the end surfaces 211 of the adjustable arm support 203.

FIG. 22C illustrates an additional embodiment of an adjustable armsupport 203 that includes a plurality of discrete indicators 201. Inthis embodiment, the indicators 201 comprise light strips (e.g., LEDstrips) that wrap around a lower surface 215, the outer surface 209, andan upper surface 217 of the adjustable arm support 203. In someembodiments, the indicators 201 may further extend onto the innersurface 213 of the adjustable arm support 203. As noted before, theindicators 201 can be individually addressable and controllable and/orconfigured to provide light of different colors and/or intensities.

FIG. 22D illustrates an additional embodiment of an adjustable armsupport 203 that includes an indicator 201 that is configured to displaytext, symbols, images, etc. For example, the indicator 201 can comprisea matrix of individually addressable light sources (e.g., LEDs) or anyother type of screen (e.g., an LCD, an LED, or an OLED screen). Such anindicator 201 may be capable of providing more complex information, suchas text or diagrams, to a user. In the illustrated embodiment, theindicator 201 is positioned on the outer surface 209 of the adjustablearm support 203. Other locations for the indicator 201 are also possible(such as any of the other surfaces) and can be used in place of or inaddition to the indicator 201 as illustrated.

FIGS. 23A and 23B illustrate cross-sectional views of an adjustable armsupport 203 including one or more indicators 201, in accordance withsome embodiments. In the illustrated embodiment, the adjustable armsupport 203 includes indicators 201 positioned on an outer surface 209and a lower surface 215 thereof. Further, in the illustrated embodiment,the indicators 201 comprise light sources, such as LEDs. FIGS. 23A and23B illustrate that the indicators 201 can be configured to providedifferent types of illumination, among other functions. For example, inFIG. 23A, the indicators 201 are configured to provide generally diffuselight that is emitted from the indicator 201 in numerous generaldirections. FIG. 23B, on the other hand, illustrates that the indicators201 can be configured to provide light that is focused in a particulardirection. For example, as shown in FIG. 23B, both the indicator 201positioned on the lower surface 215 and the indicator 201 positioned onthe outer surface 209 are configured to provide light that is focusedtowards the ground 219. As will be described in more detail below withreference to FIGS. 27A and 27B, light which illuminates the ground canbe used for general illumination and/or to identify one or more zonesaround a robotic medical system. In some embodiments, light which isilluminated downward, whether directed specifically downward or not, maybe beneficial as it may be more easily seen when components of therobotic system are covered by a sterile drape.

FIG. 24 illustrates a cross-sectional view of an adjustable arm support203 including indicators 201 that are embedded within the adjustable armsupport 203, in accordance with some embodiments. In the illustratedembodiment, the indicators 201 comprise light sources, such as LEDs. Thelight from the indicators 201 can be directed in desired directionsusing light guides 221. As shown in the illustrated embodiment of FIG.24, the light guides 221 can be configured to direct light emitted fromthe indicators 201 towards the ground 219. This, however, need notalways be the case, and the light guides 221 can be configured to orientthe light from the indicators in other directions.

As mentioned above, the indicator(s) 201 can be configured withdifferent segments or zones that can be individually controlled. FIG. 25illustrates an example adjustable arm support 203 that includes anindicator 201 that comprises a plurality of individual zones 223, 225,227. In the illustrated embodiment, the indicator 201 comprises an LEDlight strip as described above with reference to FIG. 22A. In theembodiment of FIG. 25, a center zone 223 and two end zones 225, 227 caneach be independently controllable such that they can be activated ordeactivated individually. As will be described below, activatingdifferent zones of the indicator 201 can be useful for indicatingdifferent states or identity information for a robotic system. AlthoughFIG. 25 illustrates three zones, other numbers of individuallycontrollable zones are also possible. For example, the indicator 201 cancomprise one, two, three, four, five, six, seven, eight, nine, ten, ormore zones. As mentioned above, in some embodiments, each light of theindicator 201 can be individually controllable.

In each of the embodiments of FIGS. 22A-25 described above, theindicators 201 comprise light sources. Other types of indicators (suchas audible indicators, for example) can also be used, in addition to orin place of the visual or light-based indicators 201. FIG. 26, forexample, illustrates an embodiment where the indicators 201 comprisesaudio devices, such as speakers, configured to provide audible alerts orindications. In the illustrated embodiment, three speaker-typeindicators 201 are illustrated on an outer face of the adjustable armsupport 203. Other numbers and placements for audible indicators 201 canbe included in other embodiments.

FIGS. 22A-26 are intended to provide examples of placement locations forindicators 201 on adjustable arm supports 203. The illustratedembodiments are not intended to be limiting and other locations andplacements for the indicators 201 on the adjustable arm supports 203 arealso possible. In the alternative, or in addition, other types ofcombinations indicators 201 may be placed on one or more of the armsupports 203. In addition, the indicators in FIGS. 22A-26 may not beexclusive from one another. For example, in some embodiments, the lightstrip in FIG. 22A can be combined with indicators on a lower surface ofthe arm support as shown in FIG. 23A.

B. Indicators on Patient Platforms.

As shown in FIGS. 21A and 21B, indicators 201 can be positioned on thepatient platform 205. The indicators 201 on the patient platform 205 canbe included in addition to or in place of the indicators 201 on theadjustable arm supports 203 described previously. In some embodiments,the indicators 201 on the patient platform 205 can share the same orsimilar functions as the indicators 201 on the adjustable arm supports203, as described above. In some embodiments, the patient platform 205is adjustable, such that an angle of the patient platform 205 can beadjusted as desired. For example, the patient platform 205 can beconfigured to allow for longitudinal and/or lateral tilt. In someembodiments, tilt of the patient platform 205 can be roboticallycontrolled.

In the illustrated embodiment, the patient platform 205 includes a headsection 229, a torso section 231, and a leg section 233. The headsection 229 can be configured to support a head of a patient, the torsosection 231 can be configured to support a torso of the patient, and theleg section 233 can be configured to support legs of the patient. Insome embodiments, one or more of these sections 229, 231, 233 isconfigured to be independently adjustable. For example, in someembodiments, an angle or pitch of one or more of these sections 229,231, 233 is configured to be independently adjustable. Adjustment of thesections 229, 231, 233 may allow the patient platform 205 to positionthe patient in various orientations that can be advantageous for amedical procedure.

As illustrated, the patient platform 205 can include one or moreindicators 201. The indicators 201 on the patient platform 205 may beany type of indicator as described above, including visual and audibleindicators. In the illustrated embodiment, the indicators 201 comprisevisual indicators configured as LED strips. As shown in the illustratedembodiment, discrete LED strips can be arranged along one or more of theedges or sides of the head section 229, the torso section 231, and theleg section 233. For example, in the illustrated embodiment, indicators201 are positioned on lateral sides of each of the head section 229, thetorso section 231, and the leg section 233. In some embodiments, theindicators 201 are included only on some of the sections 229, 231, 233.For example, the indicators 201 may be positioned only on the torsosection 231.

Further, in the illustrated embodiment, indicators are also positionedon ends of the patient platform 205. As shown in FIGS. 21A and 21B, anindicator 201 is included on the end of the head section 229. Anindicator 201 can also be included on an end of the leg section 233.

Positioning the indicators 201 on more than one side of the patientplatform 205 can increase the likelihood that users located at differentpositions around the table can see the indicators 201. When positionedon multiple sides of the patient platform 205, the indicators 201 can beconsidered to “wrap around” the patient platform 205 as described above.

Although illustrated as LED strips, indicators 201 on the patientplatform 205 can embody other forms. For example, other types of visualand audible indicators 201 can be used. Further, the principlesdescribed above with regard to the indicators 201 on the adjustable armsupports 203 may also be applied to the indicators 201 on the patientplatform 205. For example, in place of LED light strips, individual LEDsor other light sources can be used, the indicators 201 can comprise oneor more screens, the indicators 201 can be configured to direct light indesired directions, the indicators 201 can be individually controllableso as to provide different zones, etc.

FIGS. 21A and 21B are intended to provide examples of placementlocations for indicators 201 on the patient platform 205. Theillustrated embodiments are not intended to be limiting and otherlocations and placements for the indicators 201 on the patient platform205 are also possible. In the alternative, or in addition, other typesof combinations indicators 201 may be placed on one or more portions ofthe patient platform 205.

Indicators 201 can be positioned on a tower. The indicators 201 on atower can be included in addition to or in place of the indicators 201on the adjustable arm supports 203 or on the patient platform 205 asdescribed previously.

C. Indicator Function.

As mentioned above, the indicators 201 described above can be configuredto communicate information about the robotic medical system to users.Such information can comprise state or identity information for thesystem. As used herein, “state information” refers broadly to anyinformation indicative of a state, status, or condition of the roboticmedical system or a component thereof. “Identity information” is alsoused broadly to refer to information that can be used to identify acomponent of a robotic medical system. Examples of state and identityinformation are provided and discussed below. Other functions and usesof the indicators 201 are also described below.

As shown in the previously described examples, in some embodiments, theindicators 201 can comprise visual indicators. As noted above, visualindicators can comprise lights positioned on the robotic medical system.Visual indicators 201 configured as lights can be configured to serveone or more purposes as described below. For example, visual indicators201 can be configured to provide illumination in the operating room. Inmany cases, robotic medical procedures are performed in darkenedoperating rooms so as to facilitate remote viewing of the roboticallycontrolled instruments on a screen or console. While low lightfacilitates remote viewing of the robotic medical procedure, sterileusers directly interacting with the patient or the robotic medicalsystem can have difficulty seeing. The visual indicators 201 can provideillumination around the robotic medical system to improve visibility forthose users. In some embodiments, the illumination provided by theindicators 201 can be oriented to illuminate a region below and aroundthe patient platform 201. This may help users in proximity to therobotic system to see while minimizing any negative impact on remoteviewers. In some embodiments, visual indicators can direct light towardsthe ground 219 as described above with reference to FIGS. 23B and 24.

FIGS. 27A and 27B are top views of an embodiment of the robotic medicalsystem 200 illustrating additional functionality that can be provided byvisual indicators 201. In these figures, only the patient platform 205and the adjustable arm supports 203 are illustrated. Additionalfeatures, such as robotic arms 207 have been omitted for clarity. Theadjustable arm supports 203 and/or the patient platform 205 (or othercomponents of the system 200) can include visual indicators 201configured as described above. The visual indicators 201 are notpictured in FIGS. 27A and 27B, but approximate areas of illuminationprovided by the visual indicators 201 are illustrated using dashedlines. In some embodiments, the areas of illumination are regions on theground that are illuminated by the visual indicators 201.

As shown in FIG. 27A, in some embodiments, visual indicators 201 can beconfigured to provide an area of illumination 235 positioned generallyaround the patient platform 205. The area of illumination 235 can beprovided, for example, by visual indicators 201 that are configured todirect light substantially downward below the adjustable arm supports203 and patient platform 205. Examples of such visual indicators 201 areshown on the lower surface 215 of the adjustable arm supports 203 ofFIGS. 23B and 24. Other locations for visual indicators 201 configuredto direct light downward are also possible. In some embodiments, thearea of illumination 235 can provide “mood” lighting for the system 200.Such mood lighting can provide an elevated user experience. In someembodiments, the color of the mood lighting can be customized. Forexample, a surgeon can select a desired color of the mood lighting. Themood lighting may also facilitate visualization of the region below andaround the patient platform 205.

FIG. 27B illustrates that, in some embodiments, the visual indicators201 can be configured to provide a larger area of illumination 237around the system 200. The larger area of illumination 237 can beprovided, for example, by visual indicators 201 that are configured todirect light outwardly and downward below the adjustable arm supports203 and patient platform 205. Examples of such visual indicators 201 areshown on the outer surface 209 of the adjustable arm supports 203 ofFIGS. 23B and 24. Other locations for visual indicators 210 configuredto direct light outwardly and downward are also possible. A larger areaof illumination 237 can further improve visibility around the system200.

In some embodiments, the area of illumination 237 can be configured toindicate a “keep out zone” in order to improve the safety of those userslocated around the patient platform 205. As noted previously, the system200 may comprise one or more robotically moveable components, such asthe adjustable arm supports 203 and/or robotic arms 207. In someembodiments, when the adjustable arm supports 203 and/or robotic arms207 are about to move and/or during movement, the visual indicators 201can provide an area of illumination 237 that corresponds to an areathrough which (or above which) the components will move. The area ofillumination 237 can provide an indication to users in the area to keepclear of that area to avoid unintentional contact with the system. Insome embodiments, for example, the area of illumination 237 can beprovided in a specific color indicative of the keep out zone. Forexample, the area of illumination 237 can be illuminated in red. Inanother example, the area of illumination 237 can flash to attract theusers' attention, while also indicating the keep out zone.

The areas of illumination 235, 237 shown in FIGS. 27A and 27B, may beapproximate. For example, the boundaries of the illumination may not beclearly defined (e.g., through the use of generally diffuse lightsources). In other embodiments, the areas of illumination 235, 237 shownin FIGS. 27A and 27B, may be definite, for example, with boundaries ofthe illumination may that are clearly defined (e.g., through the use ofcrisp or focused light sources). In some embodiments, to provide welldefined boundaries, the indicators 201 may comprise lasers configured toproject clearly onto the floor,

In some embodiments, the visual indicators 201 can provide differenttypes of illumination based on different functions of the system. Forexample, in the embodiments shown in FIGS. 27A and 27B, for a firstfunction (e.g., the mood lighting as shown in FIG. 27A), the visualindicators 201 can illuminate at a first intensity (e.g., a lowerintensity), while for a second function (e.g., the “keep out zone”lighting as shown in FIG. 27B), the visual indicators 201 can illuminateat a greater intensity. In addition, in some embodiments, for the firstfunction, the visual indicators 201 can provide a constant light, whilefor the second function, the visual indicators 201 can provide anon-constant light that flashes, blinks, or otherwise has variableintensity. The visual indicators 201 can also incorporate differentcolor lights to signify different functions.

In other embodiments, the first function (e.g., the mood lighting) canbe provided by a first visual indicator 201 and the second function(e.g., the keep out zone lighting) can be provided by a second visualindicator 201. For example, the first function can be provided with thevisual indicator 201 on the bottom or lower surface 215 of theadjustable arm support 203 in FIGS. 23B and 24, and the second functioncan be provided with the visual indicator 201 on the outer surface 209of the adjustable arm support 203 in FIGS. 23B and 24. Configuringdifferent visual indicators 201 for different functions can allow thevisual indicators to provide both functions at the same time.

As described above with reference to FIG. 25, indicators 201 can beconfigured with independently configurable segments or zones. Activating(e.g., lighting up) indicators 201 within certain zones can provideseveral useful functions. In some embodiments, visual indicators 201 canbe provided whereby different segments or zones of the visual indicators201 light up depending on the purpose of the communication. FIGS.28A-28D illustrate various functionality that can be provided byindependently activating different zones or segments of the indicators201.

FIG. 28A illustrates a side view of the system 200 with the adjustablearm support 203 in a storage configuration below the patient platform205. In the illustrated embodiment, the adjustable arm support 203includes a visual indicator 201 configured as an LED strip having acenter zone 223 and two end zones 225, 227 as described above withreference to FIG. 25. In some embodiments, with the robotic system 200in a first state or configuration, the three zones 223, 225, 227 of thevisual indicator 201 (or combinations of the zones) can light up as awarning during deployment and stowing motion.

FIG. 28B illustrates that, with the robotic system 200 in a second stateor configuration, different segments of the light strip can light up tohighlight pinching dangers or warnings. For example, as illustrated, endzones 225, 227 can be activated to indicate a pinching danger betweenthe ends of the adjustable arm support 203 and a base 239 of the system200. In some embodiments, different color lights, flashing patterns,and/or different illumination intensity patterns can also be used on thedifferent zones 225, 223, 227 of the visual indicator to indicatedifferent functionality. For example, during a stowing motion, all threezones 223, 225, 227 can illuminate, with the end zones 225, 227providing a different color or illumination pattern to indicate apinching danger. As another example, visual indicators 201 can be usedto minimize or reduce a trip hazard and/or to facilitate promptdiscovery of any buttons or plugs located at or around the base of thepatient platform. Such buttons may include, but are not limited, toactuators required in an emergency scenario. For example, portions ofthe indicators 201 corresponding to the locations of the buttons orplugs can light up in order to warn users in the area of their presenceand/or to help the users find them more easily.

FIG. 28C illustrates a perspective view of the system 200, including theadjustable arm supports 203, a plurality of robotic arms 207, and thepatient platform 205. In the illustrated embodiment, a visual indicator201 is provided along the outer surface 209 of the adjustable armsupport 203. As described above with reference to FIGS. 12-14, theadjustable arm support 203 can be configured for a wide variety ofmotions. FIG. 28C illustrates an example sweeping motion (illustratedwith the dashed arrow), wherein the adjustable arm support 203 is sweptupward. This motion may be used, for example, to move the robotic arms207 into position for a robotic medical procedure. During this movementstate, the visual indicator 201 (or portions thereof, includingcombinations or patterns of the portions) may light up along its lengthto provide an indication to surrounding users of this movement.

FIG. 28D illustrates another motion of the adjustable arm support 203wherein the adjustable arm support 203 translates relative to thepatient platform 205 (illustrated with the dashed arrow). As shown inFIG. 28D, during this movement state, an end zone 227 of the visualindicator may be activated to indicate the direction of motion of theadjustable arm support. In the illustrated embodiment, the end zone 227wraps around the end of the adjustable arm support 203. Thisconfiguration can allow users standing in front of the patient platformto see the indication. In some embodiments, a moving pattern of lightsalong the adjustable arm support 203 may also provide an indication of atranslational movement of the adjustable arm support 203.

The indicators 201 can also be configured to provide identityinformation for components of the robotic medical system 200. FIG. 29A,for example, illustrates an embodiment of the robotic medical system200, wherein the indicators 201 are configured to provide identityinformation for the robotic arms 207. In FIG. 29A, the system 200comprises three robotic arms 207A, 207B, 207C mounted on an adjustablearm support 203. As illustrated, the adjustable arm support 203comprises an indicator 201 configured as an LED strip as describedabove. Indicator regions 201A, 201B, 201C of the indicator 201 can beilluminated to identify each of the robotic arms 207A, 207B, 207C. Forexample, a first region 201A can illuminate in a first color to identifythe first robotic arm 207A. The first region 201A can be, for example, aportion of the indicator 201 in proximity to a base of the first roboticarm 207A. Similarly, a second region 201B can illuminate in a secondcolor to identify the second robotic arm 207B. The second region 201Bcan be, for example, a portion of the indicator 201 in proximity to abase of the second robotic arm 207B. A third region 201C can illuminatein a third color to identify the third robotic arm 207C. The thirdregion 201C can be, for example, a portion of the indicator 201 inproximity to a base of the third robotic arm 207C.

In this way, users can identify each of the robotic arms 207A, 207B,207C by referring to the first, second, and third colors respectively.The first, second, and third colors may also be visible to a user thatis controlling the robotic system 200 (e.g., a surgeon). The surgeon oruser that is controlling the robotic system 200 is often not sterile,and thus is unable to interact directly with the robotic system 200without scrubbing in, which can be a time consuming process. Still,during a robotic system, the surgeon may desire to have one or morecomponents of the robotic system adjusted. The surgeon can refer to thefirst, second, and third colors to direct sterile users to the correctcomponents of the robotic system 200.

Although described with reference to colors, the indicator 201 andindicator regions 201A, 201B, 201C can be configured to display identityinformation in different ways. For example, in some embodiments, theindicator 201 and indicator regions 201A, 201B, 201C can be configuredto display identity via different patterns of illumination, changes inlight intensity, sound, etc. In embodiments wherein the indicator 201 isconfigured as a screen (e.g., as shown in FIG. 22D), identityinformation can be displayed through text on the screen. For example,the indicator regions 201A, 201B, 201C associated with robotic arms207A, 207B, 207C can display “arm 1,” “arm 2,” and “arm 3,” for example.Additionally, although identity information has been described abovewith reference to robotic arms 207, identity information can becommunicated with the indicator 201 for other components of the roboticsystem 200. For example, identity information can be related to medicalinstruments connected to the robotic arms 207, the adjustable armsupports 203, the patient, the patient platform 205, etc. Additionally,identity information can be provided on indicators 201 providedelsewhere on the robotic system 200, such as on indicators 201 on thepatient platform 205.

FIG. 29B is a perspective view of an embodiment of the robotic medicalsystem 200 illustrating that the indicator 201 can be configured toprovide an indication related to movement of robotic arms 207. Asdescribed above, in some embodiments, the robotic arms 207 may bemovably mounted on the adjustable arm support 203. For example, a baseof the robotic arm 207 can translate along the adjustable arm support203. During this motion, there can be a risk of inadvertent contactbetween the robotic arm 207 and users in the vicinity. FIG. 29Billustrates that the indicator 201 can be configured to provide anindication of the motion of the robotic arm 207 to alert users to themotion of the arm.

For example, in FIG. 29B, the robotic arm 207 is (or is about to move)from a first location to a second location in the direction illustratedwith the dashed arrow. A first indicator region 201A1 of the indicator201 can indicate the current location of the robotic arm 207 and asecond indicator region 201A2 can show the final position of the roboticarm 207. In some embodiments, a path between the first indicator region201A1 and the second indicator region 201A2 can also be shown. Othermethods for illustrating movement of the robotic arms 207 can also beused. Further, motion information for other components of the roboticsystem 200 can be provided with the indicators 201. As shown anddescribed, in some embodiments, the indicators 201 can advantageously beconfigured to provide lighting that is capable of dynamically shiftingalong a length of the adjustable arm support 203 and/or patient platform205 to track the movable robotic arms 207. For example, in theembodiment illustrated in FIG. 29A, the indicator 201 can compriselights that can illuminate on the adjustable arm support 203 immediatelyadjacent to respective robotic arms 207, and, as the robotic arms 207move, the lights can shift such they follow the position of the movablerobotic arms 207, as shown in FIG. 29B.

In some embodiments, indicators 201 may be configured to provide anindication of a collision between components of the system, such as acollision between two robotic arms. For example, if two robotic arms 207collide, indicators on the arm can be activated such that the collisioncan quickly and easily be identified.

In some embodiments, indicators 201 provide state information aboutmedical instruments, such as medical instruments connected to therobotic arms 207. For example, indicators 201 can provide an indicationthat the system 200 is in an instrument docking state or that aninstrument has been successfully docked to a robotic arm.

In some embodiments, the robotic systems can include torque sensors inor associated with the arms such that any collision can immediatelytrigger an emergency stop of the arm motion. In some embodiment, thesystem can be designed such that a deployment path or footprint size ofthe arms designed such that footprint increase is kept to a minimum. Insome embodiments, audible indicators are configured to provide soundalarms while arms are deploying to alert everyone in the room to stopwhat they are doing and pay attention to the arms. In some embodiments,audible indicators are configured to provide vocal notifications fromthe system. For example, an audible indicator may state, “Attention—armsare deploying. Please step away from surgical bed.” Different variationsand combinations of indicators may be implemented depending on theparticular application or medical procedure.

D. Indicators on Tower: Subsystem Component Signifier

As shown in FIG. 30, indicators 201 a-201 f can be positioned on thetower 240. The indicators 201 a-201 f on the tower 240 can be includedin addition to or in place of the indicators 201 on the adjustable armsupports 203 described previously. The indicators 201 a-201 f on thetower 240 can be included in addition to or in place of the indicators201 on the patient platform 205 described previously. In someembodiments, the indicators 201 a-201 f on the tower 240 can share thesame or similar functions as the indicators 201 on the adjustable armsupports 203 or the patient platform 205, as described above.

The system 10 may also include a movable tower 30, which may beconnected via support cables to the cart 11 to provide support forcontrols, electronics, fluidics, optics, sensors, and/or power to thecart 11. Placing such functionality in the tower 30 allows for a smallerform factor cart 11 that may be more easily adjusted and/orre-positioned by an operating physician and his/her staff. Additionally,the division of functionality between the cart/table and the supporttower 30 reduces operating room clutter and facilitates improvingclinical workflow. While the cart 11 may be positioned close to thepatient, the tower 30 may be stowed in a remote location to stay out ofthe way during a procedure.

The tower 240 may include component(s) of a computer-based controlsystem that stores computer program instructions, for example, within anon-transitory computer-readable storage medium such as a persistentmagnetic storage drive, solid state drive, etc. The execution of thoseinstructions, whether the execution occurs in the tower 240 or inanother system component may control the entire system or sub-system(s)thereof. For example, when executed by a processor of the computersystem, the instructions may cause the components of the robotics systemto actuate the relevant carriages and arm mounts, actuate the roboticsarms, and control the medical instruments. For example, in response toreceiving the control signal, the motors in the joints of the roboticsarms may position the arms into a certain posture.

The tower 240 may also include a pump, flow meter, valve control, and/orfluid access in order to provide controlled irrigation and aspirationcapabilities to the system that may be deployed through the endoscope.These components may also be controlled using the computer system of thetower 240.

The tower 240 may include a voltage and surge protector designed toprovide filtered and protected electrical power to the cart, therebyavoiding placement of a power transformer and other auxiliary powercomponents in the cart, resulting in a smaller, more moveable cart.

The tower 240 may also include support equipment for the sensorsdeployed throughout the robotic system. For example, the tower 240 mayinclude optoelectronics equipment for detecting, receiving, andprocessing data received from the optical sensors or cameras throughoutthe robotic system. In combination with the control system, suchoptoelectronics equipment may be used to generate real-time images fordisplay in any number of consoles deployed throughout the system,including in the tower 240. Similarly, the tower 240 may also include anelectronic subsystem for receiving and processing signals received fromdeployed electromagnetic (EM) sensors. The tower 240 may also be used tohouse and position an EM field generator for detection by EM sensors inor on the medical instrument.

The tower 240 may also include a console 242 in addition to otherconsoles available in the rest of the system, e.g., console mounted ontop of the cart. The console 242 may include a user interface and adisplay screen, such as a touchscreen, for the physician operator.Consoles in the system are generally designed to provide both roboticcontrols as well as preoperative and real-time information of theprocedure, such as navigational and localization information of theendoscope. When the console 242 is not the only console available to thephysician, it may be used by a second operator, such as a nurse, tomonitor the health or vitals of the patient and the operation of thesystem, as well as to provide procedure-specific data, such asnavigational and localization information. In other embodiments, theconsole 242 is housed in a body that is separate from the tower 240.

The tower 240 may be coupled to the cart and endoscope through one ormore cables or connections. In some embodiments, the supportfunctionality from the tower 240 may be provided through a single cableto the cart, simplifying and de-cluttering the operating room. In otherembodiments, specific functionality may be coupled in separate cablingand connections. For example, while power may be provided through asingle power cable to the cart, the support for controls, optics,fluidics, and/or navigation may be provided through a separate cable.

In some embodiments, the tower can include a viewer 244. As shown inFIG. 30, the viewer can depict different images of a surgical site, aswell as a graphical image of the robotic system.

In some embodiments, the viewer 244 can be used to identify to thephysician or staff how the indicators 201 are related to othercomponents of the system. The viewer 244 can include functionality forreceiving inputs. For example the viewer 244 can be a touchscreenmonitor.

As illustrated, the tower 240 can include one or more indicators 201.The indicators 201 on the tower 240 may be any type of indicator asdescribed above, including visual and audible indicators. In theillustrated embodiment, the indicators 201 comprise visual indicatorsconfigured as LED strips. As shown in the illustrated embodiment,discrete LED strips can be arranged along one or more of the edges orsides of the tower 240. For example, in the illustrated embodiment,indicators 201 are positioned on lateral sides of tower 240.Advantageously, providing indicators 201 on the moveable tower 240 thatare separate from the patient platform can add to the number oflocations in an operating room where such indicators may conveyinformation.

Although illustrated as LED strips, indicators 201 on the patientplatform 240 can embody other forms. For example, other types of visualand audible indicators 201 can be used. Further, the principlesdescribed above with regard to the indicators 201 on the adjustable armsupports 203 and the patient platform 205 may also be applied to theindicators 201 on the tower 240. For example, in place of LED lightstrips, individual LEDs or other light sources can be used, theindicators 201 can comprise one or more screens, the indicators 201 canbe configured to direct light in desired directions, the indicators 201can be individually controllable so as to provide different zones, etc.

FIG. 30 is intended to provide an example of placement locations forindicators 201 on the tower 240. The illustrated embodiments are notintended to be limiting and other locations and placements for theindicators 201 on the tower 240 are also possible. In the alternative,or in addition, other types of combinations indicators 201 may be placedon one or more portions of the tower 240.

Mounting indicators 201 to the tower 240 may be beneficial as it they bemore easily seen when components of the robotic system are covered by asterile drape.

FIG. 31 illustrates another example embodiment. In this embodiment,indicators 201 a, 201 b, 201 c, 201 d, 201 e, and 201 f are mounted on atower 246. In some embodiments, the various indicators 201 can map tovarious robotic arms. In some embodiments the robotic arms may includeindicators 201. The color or other properties of the indicators 201 onthe robotic arms may correspond to the color or other properties ofassociated indicators 201 on a tower or other subsystem, and vice versa.For example, a robotic subsystem component can signify manipulatorlocation and state. The location and state can be mapped to a userinterface that communicates additional information to the user, such asmitigation guidance. In the present embodiment, each of the indicators201 a. 201 b, 201 c, 201 d, 201 e, and 201 f corresponds to a differentrobotic arm, thereby advantageously providing a unique indicator foreach of the arms. For example, in some embodiments, should one of theindicators change from a pre-set color (e.g., blue) to a different color(e.g., red), the indicator on the tower can signify a state orinformation change on a particular robotic arm. This is particularlyadvantageous if one of multiple robotic arms is deemed to have a fault.Upon detection of the fault by a surgeon or operating room assistant,action can be taken to remedy the fault. Upon remediation of the fault,the indicator on the tower can revert back to its pre-set color.

In some embodiments, when a current state (e.g., normal operating stateor fault) is detected in one of the robotic arms, an indicator 201 onthe tower can also be displayed on the viewer 244 on top of thegraphical image, as shown in FIG. 30. The indicator on the graphicalimage of the viewer 244 advantageously enables personnel to easilyidentify an arm location whereby a status change may have taken place.Accordingly, the present application provides indicators in multiplelocations (e.g., three or more), including the robotic arms themselves(as described further in FIGS. 32 and 33), the sides of the tower, andin a graphical image displayed in a viewer of the tower.

FIG. 32 depicts a robotic system 300. The system 300 can be similar insome respects to the systems 100, 140A described above with reference toFIGS. 12-14. For example, the adjustable arm supports 303 can be similarto the adjustable arm supports 105, and the patient platform 305 can besimilar to the patient platform 101 previously described. The patientplatform 305 is configured to support a patient during a robotic medicalprocedure. The adjustable arm supports 303 can be configured so as to bemoveable or adjustable relative to the patient platform 305, in asimilar manner as described above with reference to the systems of FIGS.12-14.

In the illustrated embodiment, the adjustable arm supports 303 include arail or bar that can be configured to support one or more robotic arms307. The adjustable arm supports 303 and robotic arms 307 can be movedbetween a wide variety of positions, for example, to facilitate arobotic medical procedure and/or to facilitate storage of the adjustablearm supports 303 and robotic arms 307 beneath the patient platform 305.As described above with reference to FIGS. 12-14, the adjustable armsupports 303 can be configured for movement in multiple degrees offreedom. For example, the adjustable arm supports 303 can move in allthree spatial directions, including up and down, and enable the roboticarms 307 that are attached thereto to be stored underneath the patientplatform 305.

In the illustrated embodiment, one or more of the robotic arms 307 canhave indicators 201. The indicators 201 on the robotic arms 307 can beassociated with indicators 201 attached to another system component suchas a tower, an arm support, or a patient platform. In some embodiments,a first indicator 201 associated with a robotic arm, and attached tosaid robotic arm, may provide first information related to secondinformation provided by a second indicator 201 associated with the samerobotic arm and attached to a different system component, such as atower, arm support, or patient platform. The first and secondinformation can be the same information.

FIG. 33 depicts a robotic system 400. The system 400 can be similar insome respects to the systems 100, 140A described above with reference toFIGS. 12-14. For example, the adjustable arm supports 403 can be similarto the adjustable arm supports 105, and the patient platform 405 can besimilar to the patient platform 101 previously described. The patientplatform 405 is configured to support a patient during a robotic medicalprocedure. The adjustable arm supports 403 can be configured so as to bemoveable or adjustable relative to the patient platform 405, in asimilar manner as described above with reference to the systems of FIGS.12-14.

In the illustrated embodiment, the adjustable arm supports 403 include arail or bar that can be configured to support one or more robotic arms407. The adjustable arm supports 403 and robotic arms 407 can be movedbetween a wide variety of positions, for example, to facilitate arobotic medical procedure and/or to facilitate storage of the adjustablearm supports 403 and robotic arms 407 beneath the patient platform 405.As described above with reference to FIGS. 12-14, the adjustable armsupports 403 can be configured for movement in multiple degrees offreedom. For example, the adjustable arm supports 403 can move in allthree spatial directions, including up and down, and enable the roboticarms 407 that are attached thereto to be stored underneath the patientplatform 405.

In the illustrated embodiment, one or more of the robotic arms 407 canhave indicators 408. The indicators 408 can be similar to the indicators201. The indicators 408 can incorporate or otherwise be controlled byone or more processors. The indicators 408 on the robotic arms 407 canbe associated with indicators 408 attached to another system componentsuch as a tower, an arm support, and/or a patient platform. In someembodiments, a first indicator 408 associated with a robotic arm, andattached to said robotic arm, may provide first information related tosecond information provided by a second indicator 201 associated withthe same robotic arm and attached to a different system component, suchas a tower, arm support, or patient platform. The first and secondinformation can comprise the same information. In some embodiments, theindicators on the robotic arm can be dynamic (e.g., as shown in FIG.32), while in other embodiments, the indicators on the robotic arm canbe static (e.g., as shown in FIG. 33).

3. Implementing Systems and Terminology.

Implementations disclosed herein provide systems, methods and apparatusfor functional lighting for robotic medical systems.

It should be noted that the terms “couple,” “coupling,” “coupled” orother variations of the word couple as used herein may indicate eitheran indirect connection or a direct connection. For example, if a firstcomponent is “coupled” to a second component, the first component may beeither indirectly connected to the second component via anothercomponent or directly connected to the second component.

Any phrases referencing specific computer-implementedprocesses/functions described herein may be stored as one or moreinstructions on a processor-readable or computer-readable medium. Theterm “computer-readable medium” refers to any available medium that canbe accessed by a computer or processor. By way of example, and notlimitation, such a medium may comprise random access memory (RAM),read-only memory (ROM), electrically erasable programmable read-onlymemory (EEPROM), flash memory, compact disc read-only memory (CD-ROM) orother optical disk storage, magnetic disk storage or other magneticstorage devices, or any other medium that can be used to store desiredprogram code in the form of instructions or data structures and that canbe accessed by a computer. It should be noted that a computer-readablemedium may be tangible and non-transitory. As used herein, the term“code” may refer to software, instructions, code or data that is/areexecutable by a computing device or processor.

The methods disclosed herein comprise one or more steps or actions forachieving the described method. The method steps and/or actions may beinterchanged with one another without departing from the scope of theclaims. In other words, unless a specific order of steps or actions isrequired for proper operation of the method that is being described, theorder and/or use of specific steps and/or actions may be modifiedwithout departing from the scope of the claims.

As used herein, the term “plurality” denotes two or more. For example, aplurality of components indicates two or more components. The term“determining” encompasses a wide variety of actions and, therefore,“determining” can include calculating, computing, processing, deriving,investigating, looking up (e.g., looking up in a table, a database oranother data structure), ascertaining and the like. Also, “determining”can include receiving (e.g., receiving information), accessing (e.g.,accessing data in a memory) and the like. Also, “determining” caninclude resolving, selecting, choosing, establishing and the like.

The phrase “based on” does not mean “based only on,” unless expresslyspecified otherwise. In other words, the phrase “based on” describesboth “based only on” and “based at least on.”

The previous description of the disclosed implementations is provided toenable any person skilled in the art to make or use the presentinvention. Various modifications to these implementations will bereadily apparent to those skilled in the art, and the generic principlesdefined herein may be applied to other implementations without departingfrom the scope of the invention. For example, it will be appreciatedthat one of ordinary skill in the art will be able to employ a numbercorresponding alternative and equivalent structural details, such asequivalent ways of fastening, mounting, coupling, or engaging toolcomponents, equivalent mechanisms for producing particular actuationmotions, and equivalent mechanisms for delivering electrical energy.Thus, the present invention is not intended to be limited to theimplementations shown herein but is to be accorded the widest scopeconsistent with the principles and novel features disclosed herein.

What is claimed is:
 1. A robotic medical system, comprising: a patientplatform configured to support a patient during a robotic medicalprocedure; a column supporting the patient platform; an arm supportcoupled to the column; at least one robotic arm coupled to the armsupport; a tower; and an indicator positioned on at least one of the armsupport, patient platform, or the tower, wherein the indicator isconfigured to indicate state or identity information of the system. 2.The system of claim 1, wherein the indicator comprises at least one of avisual indicator and an audible indicator.
 3. The system of claim 1,wherein the arm support comprises an adjustable arm support configuredto move the at least one robotic arm relative to the patient platform.4. The system of claim 3, wherein the adjustable arm support isconfigured to move the at least one robotic arm from a stowed positionbelow the patient platform to a deployed position wherein at least aportion of the at least one robotic arm is positioned above the patientplatform.
 5. The system of claim 1, wherein the arm support comprises abar extending along an axis between a first end and a second end, andwherein the at least one robotic arm is movably mounted to the bar suchthat the at least one robotic arm can translate along the bar.
 6. Thesystem of claim 5, wherein the indicator comprises a visual indicator.7. The system of claim 6, wherein the visual indicator is positioned onat least one of a top side, an outer side, an inner side, and a bottomside of the bar.
 8. The system of claim 7, wherein the visual indicatorextends onto the first end and the second end of the bar.
 9. The systemof claim 1, wherein the visual indicator comprises a strip of lightemitting diodes (LEDs).
 10. The system of claim 1, wherein the stateinformation comprises information about movement of at least one of thearm support and the at least one robotic arm.
 11. The system of claim10, wherein the state information indicates a direction of movement ofthe arm support.
 12. The system of claim 11, wherein the direction ofmovement comprises a sweeping movement of the arm support.
 13. Thesystem of claim 11, wherein the direction of movement comprises atranslating movement of the arm support.
 14. The system of claim 10,wherein the state information indicates a direction of movement of theat least one robotic arm along the arm support.
 15. The system of claim1, wherein the state information comprises an identifier for the atleast one robotic arm.
 16. The system of claim 1, wherein the stateinformation comprises first state information and second stateinformation.
 17. The system of claim 16, wherein the first stateinformation comprises at least one of: a stand by state, a poweredstate, an active state, a ready state, an error state and an emergencystop state.
 18. The system of claim 16, wherein the second stateinformation is configured to indicate movement of the arm support. 19.The system of claim 18, wherein the visual indicator is configured toindicate the first state information and the second state informationconcurrently.
 20. The system of claim 2, wherein the visual indicator isconfigured to illuminate a zone around the system indicative of an areathrough which the arm support will move to provide a visual indicationof a zone of danger.